The Prevalence and Pattern of Traditional Herbal Medicine Use during Pregnancy, Labour, and Postpartum: Implications for Prevention of Mother to Child Transmission of HIV in South Africa
,
Abstract
The use of traditional herbal medicines (THM) is widespread among pregnant women in many African societies. Cultural beliefs and social norms largely influence the use of THM. However, its use during pregnancy is not freely discussed during antenatal care and the extent of its use remains unknown. The aim of the study was to determine the prevalence and pattern of THM use during pregnancy, labour, and post-delivery. The study was a quantitative cross-sectional design using a researcher administered questionnaire. Postnatal women enrolled in the prevention of mother to child transmission of HIV (PMTCT) were recruited from healthcare facilities in a rural South African sub-district. Summary and inferential statistics were computed using STATA 14.0 statistical package. The sample consisted of 399 women with mean age of 28 years. A high proportion (158/42.5) were receiving antiretroviral treatment. The prevalence of THM use was 23% and 76/87.4% took THM in the second trimester of pregnancy, 50/57.5% used THM throughout pregnancy, and 27/60% ingested THM when labour started. The majority (50/58.1%) used one type of THM and 35/41.5% used up to four types. The prevalence of THM use on babies was 44%, 82/54.2% were introduced to THM before three months, and 22/14.2% within their first week of life. A third 52/32.3% of babies received more than one concoction of herbal medicines. The women took THM to protect mother and baby from evil spirits as well as to increase labour pains and shorten the duration of labour. The use of THM on the baby was despite the women being enrolled in the PMTCT program which advocates exclusive breastfeeding (EBF) in the first six months. Mixed feeding practices including the use of THM on the baby before the end of the period of EBF have a negative impact on the elimination of vertical transmission of HIV.
De Wet H, Ngubane S. Traditional herbal remedies used by women in a rural community in northern maputaland (south africa) for the treatment of gynaecology and obstetric complaints. S Afr J Bot 2014;94:129-139.
Panganai T, Shumba P. The african pitocin-a midwife’s dilemma: the perception of women on the use of herbs in pregnancy and labour in zimbabwe, gweru. Pan Afr Med J 2016;25:9.
WHO. Background of WHO Congress on Traditional Medicine. World Health Organization. Geneva . Available at: https://www.who.int/medicines/areas/traditional/congress/congress_background_info/en/Y. 2008.
Aborigo RA, Allotey P, Reidpath DD. The traditional healer in obstetric care: a persistent wasted opportunity in maternal health. Soc Sci Med 2015;133:59-66.
M'soka NC, Mabuza LH, Pretorius D. Cultural and health beliefs of pregnant women in zambia regarding pregnancy and child birth. curationis 2015;38:1-7.
York T, De Wet H, Van Vuuren S. Plants used for treating respiratory infections in rural Maputaland, KwaZulu-Natal, South Africa. J Ethnopharmacol 2011;135:696-710.
Frawley J, Adams J, Steel A, Broom A, Gallois C, et al. Women's use and self-prescription of herbal medicine during pregnancy: an examination of 1,835 pregnant women. Women's Health Issues 2015;25:396-402.
Rahman A, Ahmad Z, Naing L, Sulaiman SA, Hamid AM, et al. The use of herbal medicines during pregnancy and perinatal mortality in Tumpat District, Kelantan, Malaysia. Southeast Asian J Trop Med Public Health. 2007;38:1150-1157.
Dove N. A return to traditional health care practices: a Ghanaian study. J Black Stud 2010;40:823-834.
Mogawane MA, Mothiba TM, Malema RN. Indigenous practices of pregnant women at Dilokong hospital in Limpopo province, South Africa. curationis 2015;38:1-8.
Maluma S, Kalungia A, Hamachila A, Hangoma J, Munkombwe D. Prevalence of traditional herbal medicine use and associated factors among pregnant women of lusaka province, zambia. J Prev Rehabil Med 2017;1:5-11.
Mugomeri E, Chatanga P, Seliane K, Maibvise C. Identifying promoters and reasons for medicinal herb usage during pregnancy in Maseru, Lesotho. Afr J Nurs Midwifery 2015;17:4-16.
Maputle SM, Mothiba TM, Maliwichi L. Traditional medicine and pregnancy management: Perceptions of traditional health practitioners in Capricorn district, Limpopo province. Stud EthnoMed 2015;9:67-75.
Mekuria AB, Erku DA, Gebresillassie BM, Birru EM, Tizazu B, et al. Prevalence and associated factors of herbal medicine use among pregnant women on antenatal care follow-up at University of Gondar referral and teaching hospital, Ethiopia: a cross-sectional study. BMC Complement Altern Med 2017;17:1-7.
Varga CA, Veale D. Isihlambezo: Utilization patterns and potential health effects of pregnancy-related traditional herbal medicine. Soc Sci Med 1997;44:911-924.
Mabina M, Pitsoe S, Moodley J. The effect of traditional herbal medicines on pregnancy outcome. S Afr Med J 1997;87:1008-1010.
Mothupi MC. Use of herbal medicine during pregnancy among women with access to public healthcare in Nairobi, Kenya: a cross-sectional survey. BMC Complement Altern Med 2014;14:432.
Nordeng H, Havnen GC. Use of herbal drugs in pregnancy: a survey among 400 Norwegian women. Pharmacoepidemiol Drug Saf 2004;13:371-380.
Van der Kooi R, Theobald S. Traditional medicine in late pregnancy and labour: perceptions of Kgaba remedies amongst the Tswana in South Africa. Afr J Tradit Complement Altern Med 2006;3:11-22.
Abrahams N, Jewkes R, Mvo Z. Indigenous healing practices and self-medication amongst pregnant women in Cape Town, South Africa. Afr J Reprod Health 2002;6:79-86.
WHO. Traditional medicine: growing needs and potential. World Health Organization. Geneva, Switzerland World Health Organization; 2002.
Illamola SM, Amaeze OU, Krepkova LV, Birnbaum AK, Karanam A, et al. Use of herbal medicine by pregnant women: what physicians need to know. Front Pharmacol 2020;10:1483.
Frawley J, Adams J, Sibbritt D, Steel A, Broom A, et al. Prevalence and determinants of complementary and alternative medicine use during pregnancy: results from a nationally representative sample of Australian pregnant women. australian and new zealand. J Obstet Gynaecol 2013;53:347-352.
Adusi-Poku Y, Vanotoo L, Detoh E, Oduro J, Nsiah R, et al. Type of herbal medicines utilized by pregnant women attending ante-natal clinic in Offinso north district: Are orthodox prescribers aware? Ghana Med J 2015;49:227-232.
Nyeko R, Tumwesigye NM, Halage AA. Prevalence and factors associated with use of herbal medicines during pregnancy among women attending postnatal clinics in gulu district, northern uganda. BMC Pregnancy Childbirth 2016;16:1-12.
Veale D, Furman K, Oliver D. South african traditional herbal medicines used during pregnancy and childbirth. J Ethnopharmacol 1992;36:185-1891.
Zamawe C, King C, Jennings HM, Fottrell E. Associations between the use of herbal medicines and adverse pregnancy outcomes in rural Malawi: a secondary analysis of randomised controlled trial data. BMC Complement Altern Med 2018;18:1-8.
Beste J, Asanti D, Nsabimana D, Anastos K, Mutimura E, et al. Use of traditional botanical medicines during pregnancy in rural Rwanda. J Glob Health Perspect 2015;2015.
Ahmed SM, Nordeng H, Sundby J, Aragaw YA, de Boer HJ. The use of medicinal plants by pregnant women in Africa: a systematic review. J Ethnopharmacol 2018;224:297-313.
El Hajj M, Holst L. Herbal medicine use during pregnancy: a review of the literature with a special focus on sub-saharan africa. Front Pharmacol 2020;11:866.
Mohlabane N, Gumede N, Mokomane Z. Attitudes towards marriage in postapartheid South Africa. Human Science Reseach Council. Pretoria, South Africa. http://ecommons.hsrc.ac.za/bitstream/handle/20.500.11910/14808/11010.pdf?sequence=1&isAllowed=y. 2019.
Dika HI, Dismas M, Iddi S, Rumanyika R. Prevalent use of herbs for reduction of labour duration in Mwanza, Tanzania: are obstetricians aware? Tanzan J Health Res 2017;19.
Mureyi DD, Monera TG, Maponga CC. Prevalence and patterns of prenatal use of traditional medicine among women at selected harare clinics: a cross-sectional study. BMC Complement Altern Med 2012;12:1-7.
Onyiapat J, Okafor C, Okoronkwo I, Anarado A, Chukwukelu E, et al. Complementary and alternative medicine use: Results from a descriptive study of pregnant women in Udi local Government area of Enugu state, Nigeria. BMC complement Altern Med 2017;17:1-7.
Ameade E, Zakaria A, Abubakar L, Sandow R. Herbal medicine usage before and during pregnancy-a study in northern ghana. Int J Complement Alt Med 2018;11:235-242.
Holst L, Wright D, Haavik S, Nordeng H. Safety and efficacy of herbal remedies in obstetrics-review and clinical implications. Midwifery 2011;27:80-86.
Tamuno I, Omole-Ohonsi A, Fadare J. Use of herbal medicine among pregnant women attending a tertiary hospital in northern nigeria. Internet J Gynecol Obstet 2011;15.
Mlambo MG, Peltzer K. Perceptions of grandmothers and HIV-infected mothers on infant feeding practices in a rural South African district. Health SA Gesondheid (Online). 2020;25:1-9.
Madiba S, Langa J. Cultural practices interfere with adherence to exclusive infant feeding: A qualitative study among HIV positive post natal women in hammanskraal, south africa: child nutrition and feeding practices. Afr J Phys Health Educ Recreat Dance 2014;20(sup-1):264-278.
Mphego Z, Madiba S, Ntuli B. The influence of the family on adherence to exclusive breastfeeding: experiences of women living in extended family households in poorly resourced communities of mpumalanga province, south africa: child nutrition and feeding practices. Afr J Phys Health Educ Recreat Dance 2014;20(sup-1):279-290.
Teni FS, Birru EM, Surur AS, Belay A, Wondimsigegn D, et al. Pattern and predictors of medicine use among households in Gondar Town, northwestern Ethiopia: a community-based medicine utilization study. BMC Res Notes 2017;10:1-8.
| Files | ||
| Issue | Vol 6, No 4, 2021 | |
| Section | Research Article(s) | |
| DOI | https://doi.org/10.18502/tim.v6i4.8274 | |
| Keywords | ||
| Cultural practices Traditional herbal medicines Pregnant women Primary health facilities Postnatal care South Africa | ||
| Rights and permissions | |
|
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
