This study revealed that about 60 plant species find applications by the TMPs of the woreda. Those plants were identified and distributed in 42 families. Families, Graminae and Solanaceae each accounts 4 (9.5%) medicinal plants followed by Fabaceae and Leguminosae, 3 (7%). But Fabaceae was the dominant family according to the conducted in Hawasa , Wayu Tuka District of Oromiya region  and Benshangul-Gumuz . In addition a study done in Spain , Korea  and Loma and Gena Bosa Districts  showed that Asteraceae has the highest number of medicinal plants. Caesalpiniaceae was the family with higher number of plants according to the study in Nigeria .
The ailments reported to be handled by the TMPs of the district are those disorders most prevalent in the district. According to the result of this study, the majority of plants were reported to treat wound followed by malaria, evil eye and anthrax. However, a study done in Hawasa  showed that stomach ache is the disease treated by large number of medicinal plants. In addition a study done in Sheko ethinic group of Ethiopia  showed that skin and gastrointestinal problems were the commonly treated diseases. According to a study in Lebanon , most medicinal plants were used to treat gastrointestinal disorders, kidney and urinary diseases as well as blood and cardiovascular diseases. Diarrhea was the commonly treated disease in Benshangul-Gumuz .This discrepancy may be the result of the difference in the climatic, ethnic, and hygienic conditions the areas. The current study is also unlike the one done in Israel . Mental illnesses were commonly treated according to the study in Kenya .
The most commonly used plant part was leaf in this study area which is in agreement with other studies. [8, 13, 15, 18, 19, 21, 23–26]. Considerable threat to the mother plant radiates to the various parts of the plant. However, root was the commonly used plant part according to a study done in Benshangul-Gumuz . Medicinal plants were formulated in various forms using various solvents and additives. They were formulated as decoctions, liquid preparations and pastes. This is supported by a study done in Korea , Israel , Gondar zuria woreda  and Hawasa . However, in a study done in Chencha  and Tewledere districts , the majority of remedies were formulated as concoctions. Practitioners prepare remedies in such a simple manner without further processing which may be due to lack of education and processing instruments. TMPs of the current study area used butter, charcoal, sugar, milk and salt as additives to increase the efficacy and potency of the remedies. The rationale behind the use of honey and sugar is just to make the formulation palatable. This is supported by a study done in Israel  and Hawasa .
This study showed that there was no harmony in measurement or unit used among practitioners. Most informants stated measuring units like cup, spoon, bottle and handful which lack accuracy. This problem was also observed in studies done elsewhere which may be due to lack of education [13, 14, 19, 28].
This study revealed that higher sizes of preparations were given orally which agrees with results of other studies [11–13, 15, 17, 22–25, 27–29]. Practitioners prefer simple routes like topical and oral due to their inability to administer remedies in other routes like intravenous. Oral administration allows relatively fast physiological action of remedies on pathogens and enhance its efficacy. However, studies conducted in Sheko ethnic group in Southwest Ethiopia  revealed that most preparations were prescribed for administration to the cutaneous route. According to the result of the current study, most formulations were given only once. This may be due to the fact that most practitioners do not know the actual dose to be given and fear the risk that comes at the end of the treatment due to over dose and continuous administration.
One-third of the medicinal plants recorded were trees. However, other research works indicate the abundant use of herbs [8, 22, 24, 25, 27, 30]. The availability of most woody plants in the area might have enforced the local inhabitants to rely on tress.
Most of the formulations were contraindicated for pregnant patients. This is due to the healers’ belief that it may harm the fetus. No contraindication is indicated for one-third of the formulations. Most preparations taken orally cause nausea, vomiting and abdominal cramp whereas, some of the preparations are free from any side effect which may be due to the lack of follow up of patients by healers once they gave remedies and due to illiteracy of the patients.
This study revealed that, only some of the formulations possessed drug food and drug–drug interactions, this may be because most practitioners are illiterate, they do not know about the interaction of their remedies with modern medicines. In addition practitioners do not follow the progress of their patients, hence have little information on drug food interaction. Synergistic reactions were observed in poly herbal preparations like in the case of remedies for evil eye.
According to this study, practitioners do not normally store remedies which is in contrast to the study done in Addis Ababa . For those medicinal plants which are not easily available and which are seasonal, practitioners collect and store in papers, horns and with in bottles. Only three percent of the total preparations are stored in cool and dry places. This may be due to the lack of modern education about drug storage and other health related issues.
A total of 127 URs from 60 species of plants were recorded which were assigned to seven use categories. Analysis of ICF shows that there exists a high evenness of plant consumption among the population which is in harmony with the study in Chencha . The low ICF for skin problems may because of a multifaceted preparation of plants required to treat disease. Majority of plant species have a number of medicinal values, which result in higher variety of use reports.
Croton macrostachyus (FL = 0.78) is reported by high number of informants (36%), hence more preferable than Euphorbia abyssinica (0.42) and Urtica simensis (0.67) in treating malaria. However, despite Allium sativum (FL = 0.75) is reported by less figures of informants (30%), than Echinops kebericho (FL = 0.64) which is mentionedd by relatively higher percentage of practitioners (34%), it seems that Allium sativum is more preferable than Echinops kebericho in treating evil eye. But a study done in Sheko  indicated that Ocimum lamiifolium, Phytolacca dodecandra, Amaranthus dubius and Amaranthus graecizans were the medicinal plants assigned with the highest FL values. This discrepancy may be the result of the differences in the type of diseases dominating the areas, and the level of availability of the medicinal plants.
According to the results of this study, drought is the most serious threat to medicinal plants followed by overgrazing. This is in conformity with the survey conducted in Gemad district  and Kilte Awulalo , but according to a study done in Loma and Gena Bosa , agricultural expansion was the major threat followed by timber and other demands. This is probably due to the increasing number of population. However, study done in Hawasa city  indicated urbanization as the most serious threat for medicinal plants.