Herbal medicine use and predictors among pregnant women attending antenatal care in Ethiopia: a systematic review and meta-analysis

Use of herbal medicine during pregnancy and associated factors among pregnant women with access to public healthcare in west Shewa zone, Central Ethiopia: sequential mixed-method study

OBJECTIVE

This study was aimed at assessing the prevalence of herbal drug use among pregnant women with access to modern medicine and associated factors in public health facilities in the west Shewa zone, Oromia regional state, Ethiopia.

DESIGN

A sequential mixed-method study approach was carried out among pregnant women and other stakeholders.

SETTING

This study was conducted at public health facilities, including 3 public hospitals and 20 health centres, in the west Shewa zone of Ethiopia.

PARTICIPANTS

A systematically selected sample of 411 pregnant women was participated in the quantitative study. For the qualitative method, focus group discussions and in-depth interviews were conducted among pregnant women attending antenatal care and key informants using an interview guide until data saturation was achieved.

PRIMARY OUTCOME

For outcome variables, the respondents were asked if they used any herbal medicine during their current pregnancy. It was then recorded as 0=no and 1=yes.

RESULTS

The prevalence of herbal medicines was found to be 19.7%. The most commonly used herbal medicines were Zingiber officinale, Ocimum gratissimum, Eucalyptus globules, Allium sativum and Rutacha lepensis. Herbal medicine use during pregnancy was significantly associated with older maternal age (adjusted OR (AOR) 2.4, 95% CI 1.2 to 5.1), urban residence (AOR 2.3, 95% CI 1.3 to 3.7) and second trimester of pregnancy (AOR 2.3, 95% CI 1.3 to 4.5).

CONCLUSIONS

In this study, one in five pregnant women uses herbal medicine, which is relatively low. Sociodemographic factors and the duration of pregnancy affected the utilisation of herbal drugs during pregnancy. The most common herbals used by pregnant women were intended to treat minor disorders of pregnancy and medical disorders such as hypertension.

Birth prevalence and risk factors of neural tube defects in Ethiopia: a systematic review and meta-analysis

OBJECTIVE

This study aims to estimate the prevalence of neural tube defects (NTDs) and to identify potential risk factors in the Ethiopian context.

STUDY DESIGN

Systematic review and meta-analysis.

STUDY PARTICIPANTS

A total of 611 064 participants were included in the review obtained from 42 studies.

METHODS

PubMed (Medline), Embase and Cochrane Library databases in combination with other potential sources of literature were systematically searched, whereby studies conducted between January 2010 and December 2022 were targeted in the review process. All observational studies were included and heterogeneity between studies was verified using Cochrane Q test statistics and I2 test statistics. Small study effects were checked using Egger's statistical test at a 5% significance level.

RESULT

The pooled prevalence of all NTDs per 10 000 births in Ethiopia was 71.48 (95% CI 57.80 to 86.58). The between-study heterogeneity was high (I2= 97.49%, p<0.0001). Birth prevalence of spina bifida (33.99 per 10 000) was higher than anencephaly (23.70 per 10 000), and encephalocele (4.22 per 10 000). Unbooked antenatal care (AOR 2.26, 95% CI (1.30 to 3.94)), preconception intake of folic acid (AOR 0.41, 95% CI (0.26 to 0.66)), having chronic medical illness (AOR 2.06, 95% CI (1.42 to 2.99)), drinking alcohol (AOR 2.70, 95% CI (1.89 to 3.85)), smoking cigarette (AOR 2.49, 95% CI (1.51 to 4.11)), chewing khat (AOR 3.30, 95% CI (1.88 to 5.80)), exposure to pesticides (AOR 3.87, 95% CI (2.63 to 5.71)), maternal age ≥35 (AOR 1.90, 95% CI (1.13 to 3.25)), maternal low educational status (AOR 1.60, 95% CI (1.13 to 2.24)), residing in urban areas (AOR 0.75, 95% CI (0.58 to 0.97))and family history of NTDs (AOR 2.51, 95% CI (1.36 to 4.62)) were associated with NTD cases.

CONCLUSION

The prevalence of NTDs in Ethiopia is seven times as high as in other Western countries where prevention measures are put in place. Heredity, maternal and environmental factors are associated with a high prevalence of NTDs. Mandatory fortification of staple food with folic acid should be taken as a priority intervention to curb the burden of NTDs. To smoothen and overlook the pace of implementation of mass fortification, screening, and monitoring surveillance systems should be in place along with awareness-raising measures.

PROSPERO REGISTRATION NUMBER

CRD42023413490.

The Determinants of Utilisation of Herbal Medicine Among Pregnant Women in the Asante Akim North District, Ghana

BACKGROUND

Pregnant women especially in the developing countries resort to herbal medicines to manage their unpleasant conditions in pregnancy. The study examined the utilization of herbal medicine among pregnant women in Asante Akim North District of Ghana.

METHODS

Purposive, random and convenient sampling techniques were used to select pregnant women visiting antenatal clinics in the selected health institutions. The theoretical underpinning of the study was the theory of planned behaviour. The sequential mixed method approach was used to draw data from the respondents. The research was a cross-sectional study and instruments used for data collection were structured questionnaire and interview guide. Data were analysed using statistical tools such as frequencies, percentages and chi-square test of independence.

RESULTS

Results indicate that over 82% of respondents had ever used herbal medicine during pregnancy and they derived greater part of their medication from herbalists. Ginger and leaves of the neem tree were the herbs regularly used and the major health problems they faced during pregnancy were waist pains, malaria and anaemia. The factors that exhibited a statistically significant association with the use of herbal medicine were income (X2 =41.601; p=0.014) and religion (X2=9.422; p=0.045).

CONCLUSIONS

The rate of use of herbal medicine by pregnant women is high in the district. The theoretical underpinning of the study has been vindicated. The findings have implications for global health given that maternal health issues engage serious attention of international donor organisations. Recommendations have been made to improve the efficacy of herbal medicine and to integrate herbal medicine into orthodox medicine.

The effects of advanced maternal age on perinatal mortality in Ethiopia: A systematic review and meta-analysis

Background

Pregnancy in women over the age of 35 years is considered advanced maternal age. The relationship between advanced maternal age and the risk of perinatal mortality is still controversial. As a result, this systematic review and meta-analysis were carried out to clarify the relationship between advanced maternal age and perinatal mortality in Ethiopia.

Methods

The following electronic databases were used for this systematic review and meta-analysis: PubMed, Web of Science, Scopus, Science Direct, Google Scholar, HINARI, and African Journals Online up to March 2022. Addis Ababa, Gondor, and Jimma University research repositories were also searched. A random-effects model was used to pool study-specific odds ratios.

Results

A total of 18 articles, including a total of 45,541 participants, were included in the meta-analysis. A total of 11 cross-sectional, 2 case-control, and 5 cohort studies were included. The overall pooled estimate indicates that women with advanced maternal age had a 1.58 higher risk of perinatal mortality compared to women in the younger age group (odds ratio = 1.58; 95% Confidence Interval: 1.13-2.03). The subgroup analysis also revealed that there were differences in the effect size as the geographical region differed. The result showed that the odd of perinatal mortality was highest in the Oromia region and lowest in the Southern Nations Nationalities and Peoples' Region.

Conclusion

The overall pooled estimate indicates that women with advanced maternal age had a 1.58-fold higher risk of perinatal mortality. Even though this risk could also be increased with other comorbid diseases, it is important for healthcare providers and other concerned stakeholders to be aware of the increased risks associated with advanced maternal age and provide different intervention programs designed to create awareness and provide counseling services to couples who seek to have a child in their later ages about the risks of advanced maternal age pregnancy on perinatal mortality and other adverse pregnancy outcomes.

Everyday Evaluation of Herb/Dietary Supplement–Drug Interaction: A Pilot Study

A lack of reliable information hinders the clinician evaluation of suspected herb–drug interactions. This pilot study was a survey-based study conceived as a descriptive analysis of real-life experiences with herb–drug interaction from the perspective of herbalists, licensed health-care providers, and lay persons. Reported dietary supplement–drug interactions were evaluated against the resources most commonly cited for the evaluation of potential supplement–drug interactions. Disproportionality analyses were performed using tools available to most clinicians using data from the U.S. Federal Adverse Event Reporting System (FAERS) and the US Center for Food Safety and Applied Nutrition (CFSAN) Adverse Event Reporting System (CAERS). Secondary aims of the study included exploration of the reasons for respondent use of dietary supplements and qualitative analysis of respondent’s perceptions of dietary supplement–drug interaction. While agreement among reported supplement–drug interactions with commonly cited resources for supplement–drug interaction evaluation and via disproportionality analyses through FAERS was low, agreement using data from CAERS was high.

Teratogenic Evaluation of 80% Ethanol Extract of Embelia schimperi Vatke Fruits on Rat Embryo and Fetuses

Introduction

Embelia schimperi Vatke (family Myrsinaceae) is a commonly consumed anthelminthic plant in Ethiopia. The plant has significant efficacy in treating intestinal worms. However, there are limited data about the safety/toxicity of the plant. Moreover, the teratogenic effect of the plant is not yet well studied despite significant number of Ethiopian mothers consuming herbal medication during their pregnancy.

Purpose

This study aimed to evaluate the teratogenic effect of the hydroalcoholic extract of E. schimperi fruit on rat embryos and fetuses.

Methods

Pregnant albino Wistar rats were treated with 80% hydroalcoholic fruit extract of E. schimperi at 250 mg/kg, 500 mg/kg, and 1000 mg/kg dosage, whilst the controls were pair-fed and ad libitum groups. Maternal food intake, maternal weight gain, number of implantations, number of prior resorptions, fetal viability, fetal weight, fetal and embryonic crown-ramp length, placental weight, placental gross morphology and histopathology of placental tissue, number of somites, embryonic system, gross/visceral morphological malformations, and ossification centers were evaluated as teratogenicity indices.

Results

The crude extract of E. schimperi did not exhibit a significant difference in most developmental indices including the development of a circulatory system, nervous system, and musculoskeletal systems among treated animals and the controls. However, histopathological evaluation of placentas from the treatment groups showed that inflammatory reactions and calcifications compared to the pair-fed and ad libitum controls.

Conclusion

Administration of the 80% hydroalcoholic extract of E. schimperi fruit during the period of organogenesis in rats did not show a significant toxic effect on embryonic and fetal developmental indices. However, it might affect the structural integrity of the placenta as it is evidenced by inflammatory reactions and calcifications of decidua basalis of rat placenta.

Maternal Health Through the Use of Herbal Medicines and Traditional Medicinal Plants for Public Health and Ancestral Culture

BACKGROUND: The use of traditional medicine for maternal health is very important, to overcome various health problems experienced by mothers, using medicinal plants in the community. Especially with the past modern medicine, the modern one is expensive in medicine compared to the traditional medicine which is much cheaper. METHODS: The criteria used in this study were the existing mothers, carried out by conducting qualitative research, and also conducting a survey that conveyed how the respondents responded to medicinal plants. RESULTS: The purpose of this study was to identify medicinal plants used by mothers for their medicinal plants and recommendations for the use of good medicinal plants among mothers to overcome health problems experienced by mothers. CONCLUSION: Various types of medicinal plants are used by mothers for health and benefits for mothers. Medicinal plants used by mothers are still limited from the information obtained by mothers on the internet, and also for hereditary factors that are culturally lacking, the rest are from neighbors. Recommendations are given to carry out the necessary studies given further studies related to medicinal plants and the preservation of existing traditional cultures.

Does Vitex Agnus-Castus L. Have Deleterious Effect on Fertility and Pregnancy Outcome? An Experimental Study on Rats for Prediction of Its Safety

Objectives

Herbal medicine is a worldwide health topic. Vitex agnus–castus L. (VAC) is a popular plant used for gynecologic problems due to its hormonal effects. The aim of this study is to reveal VAC extract effect on fetus when this herb is used started from antenatal period or during pregnancy.

Methods

Performed from starting day of January 2019 till February 2019, 48 rats were assigned in randomly divided eight-member six groups control (C1), treated group with 365 mg/kg VAC from initiation of insemination (T1) and 30 days prior to pregnancy (T2), control that underwent caesarean section on 15th day of gestational age (C2) and treated group with 365 mg/kg VAC from initiation of insemination (T3) and 30 days prior to pregnancy (T4) that underwent caesarean section. Weight, sex and number of fetuses, abortion and still birth rate and estradiol level were evaluated using t-test by SPSS software.

Results

We showed increased weight among T1 group considering totally and sex-dependent which is significant (all p-value < 0.05). We also detected significantly decreased weight in T2 in total (p-value < 0.0001) and when considering female fetuses (0.043) but not males (0.17). Although the results showed slightly non-significant increased weight among fetuses of T3 (totally or based on the fetus sex) compared to the control group (C2), T4 group had statistically decreased weight compared to control group. Pregnancy rate and pregnancy outcome were affected by VAC usage. The time of VAC initiation also affected live birth and abortion rates.

Conclusion

VAC extract may affect pregnancy rate, live birth rate, abortion and stillbirth rates. Its effect on the weight and the sex showed dual pattern depends on the time of initiation and pregnancy trimester of evaluation. Prescribing this medicinal plant for patients being prone to pregnancy should be with caution. Further study is recommended.

Use of Herbal Medicines Among Breastfeeding Mothers in Tanzania: A Cross-Sectional Study

Background: There are limited data on the use of herbal medicines (HM) among breastfeeding mothers, despite the fact that knowledge of the possible benefits or harms of HM use has a direct relationship with the health of infants, especially in resource-limited countries. The study aims to determine the prevalence and factors associated with HM use among breastfeeding mothers in Tanzania. Methods: The study followed a cross-sectional design using a structured survey questionnaire. Survey participants were recruited from the reproductive and child health clinic at Uhuru health center in Morogoro, Tanzania. The survey instrument comprised of 34 questions, including demographic information, the pattern of HM use during breastfeeding, and women's perceptions of HM. Chi-square test and logistic regression were used for data analysis using SPSS ver. 24.0. Results: The majority of the respondents (53.8%) used HM during breastfeeding. The most commonly used HM was black pepper (Piper nigrum L.; 80.0%), followed by pumpkin seeds (Cucurbita pepo L.; 18.0%). About one-third (27.5%) of HM users discussed their use with their healthcare providers. In addition, higher education levels and low breastmilk supply were identified as potential predictors of HM use. Conclusion: The practice of HM use among breastfeeding mothers in Tanzania is popular to ease breastfeeding difficulties. However, the issue of the safety or effectiveness of HM is still an unknown agenda. This awakens the need to evaluate HM's safety, efficacy, and quality through pharmacological studies for scientific evidence. Lastly, a clinical guideline should be developed in healthcare settings to promote open dialogues between the healthcare providers and mothers to ensure the safe use of HM.

Traditional practices during pregnancy and childbirth among mothers in Shey Bench District, South West Ethiopia

Objective:

Pregnancy and child birth is the most critical period in the health of women and children and the objective of this study was to explore traditional practices among mothers during pregnancy and delivery in Shey Bench District, South West Ethiopia, and we hope the evidence generated could benefit decision-makers and concerned bodies who are interested in this important public health issue.

Methods:

A descriptive qualitative study, which is an ideal approach when an uncomplicated description is desired that focuses on the details of what, where, when, and why of an event or experience, was conducted from March to May 2019 in Shey Bench District and a purposively selected 43 women have participated in the study. In-depth interviews and key informant interviews were conducted and data were analyzed by Open code 4.2 software and summarized following content analysis approach. Findings were narrated based on the major categories and study participants’ words were used as quotes.

Results:

In this study, it was found that mothers have experience of traditional practices mainly of abdominal massage, use of herbs, prohibition of some food types, and strenuous physical exercise during pregnancy and childbirth. As of the reasons; mothers reported as traditional practices help them to make the labor easy and fast, alleviate discomforts, and avoid unwanted big size of the fetus. Experience of health problem following practice of traditional practices like vaginal bleeding and child death were also reported. However, some study participants indicated as community members are changing their mind because of getting advice from health professionals.

Conclusion:

Although traditional practices were found to be exercised by mothers believing to get benefits, there were reports of health side effects on mothers and the fetus from applying abdominal massage, herbal medicine, food prohibition, and strenuous physical exercise during their pregnancy and childbirth. Therefore, concerned working bodies shall design and implement necessary interventions, particularly health education programs to bring a better a change against harmful traditional practices.

Knowledge and Attitude of Women Towards Herbal Medicine Usage During Pregnancy and Associated Factors Among Mothers Who Gave Birth in the Last Twelve Months in Dega Damot District, Northwest Ethiopia

Background

The use of herbal medicine is increasing globally, particularly in developing countries including Ethiopia, yet little is known regarding its effect and safety during pregnancy. Pregnant women prefer herbal medicine due to easy accessibility, traditional and cultural beliefs, and comparatively low cost. This study aimed to assess women’s knowledge and attitude towards the effects of herbal medicine usage during pregnancy and associated factors among women who gave birth in the last twelve months in Dega Damot district.

Methods

A community-based cross-sectional study was conducted from January 1st to February 30th, 2021. A total of 872 women were selected using a stratified cluster sampling technique. Data were collected by face-to-face interviews using a structured, pretested, and interviewer-administered questionnaire. Data were entered into EPI data version 4.6 and exported to SPSS version 25 for analysis. Multivariable logistic regression was done and a p-value of ≤ 0.05 was used to declare the level of significance.

Results

Women’s knowledge and positive attitude towards the effects of herbal medicine usage during pregnancy was 49.1% (95% CI: 46–52) and 57.3% (95% CI: 54–61), respectively. Access to media, had antenatal care visit, being urban dweller, history of herbal medicine usage, and a short distance to reach the nearby health facility were significantly associated with women’s knowledge about effects of herbal medicine usage. Besides, being primiparous and short traveling time to reach the nearby health facility was significantly associated with women’s attitude towards the effects of herbal medicine usage during pregnancy.

Conclusion

Women’s knowledge and positive attitude towards the effects of herbal medicine usage during pregnancy was low. It is important to design strategies to improve the accessibilities of maternal health services, and expand access to media will have a great role in improving women’s knowledge and attitude towards herbal medicine usage during pregnancy.

Herbal Medicines-Are They Effective and Safe during Pregnancy?

Since the teratogenicity of Thalidomide has been proven, herbal products are more commonly used in pregnancy to not only relieve morning sickness but also to fight infections. These products are frequently considered as natural and therefore harmless. However, herbs contain a number of active substances that, when used during pregnancy, can affect the development of the fetus. Often, pregnant women do not consult the usage of herbal medicines with a physician. The access to these products is easy and treatment of certain ailments with the use of herbs is common in many countries. The aim of the present literature review was to discuss available data regarding the efficacy and safety of cranberry, chamomile, Echinacea purpurea, garlic, ginger, Ginkgo biloba, and peppermint, which are used to counteract the most common ailments during pregnancy, i.e., infections and pregnancy-related ailments (e.g., nausea and vomiting, dizziness, and headache). Analysis of available data showed that ginger is one of the most extensively analyzed herbal remedies. The dose of ginger below 1000 mg per day may help to relief hypereremesis gravidarum, and such an amount of ginger did not increase frequency of adverse effects for either woman or developing fetus. Data regarding other herbs are most often heterogeneous and give conflicting results with no clear conclusions. However, all herbal products should be used with a special caution in pregnancy. Further high-quality human studies should be determined to confirm the safe doses of herbal products which could be used by pregnant or breast-feeding women.

African Herbal Medicines: Adverse Effects and Cytotoxic Potentials with Different Therapeutic Applications

The African continent is naturally endowed with various plant species with nutritional and medicinal benefits. About 80% of the people in developing countries rely on folk medicines to treat different diseases because of indigenous knowledge, availability, and cost-effectiveness. Extensive research studies have been conducted on the medicinal uses of African plants, however, the therapeutic potentials of some of these plants has remained unexploited. Over the years, several studies have revealed that some of these African floras are promising candidates for the development of novel drugs. Despite the plethora of studies on medicinal plant research in Africa, there is still little scientific data supporting the folkloric claims of these plants. Besides, safety in the use of folk medicines has been a major public health concern over the year. Therefore, it has become mandatory that relevant authority should take measures in safeguarding the populace on the use of herbal mixtures. Thus, the present review extracted relevant information from different scientific databases and highlighted some problems associated with folk medicines, adverse effects on reproductive systems, issue about safety due to the toxicity of some plants and their toxicity effects with potential therapeutic benefits are discussed.

Understanding forgotten exposures towards achieving Sustainable Development Goal 3: a cross-sectional study on herbal medicine use during pregnancy or delivery in Tanzania

Background

In most of the sub-Sahara African countries, use of herbal medications is widely practiced during pregnancy or delivery for various reasons despite uncertainties on their pharmacological profiles. Use of unregistered herbal medicines has the potential of causing adverse health effects to the mother and the newborn, thus deterring achievement of Sustainable Development Goal 3, which aims to “ensure healthy lives and promote well-being for all at all ages”. One of the targets is on reduction of morbidity and mortality among mothers and newborns. This study investigated use of herbal medicines and predictors of usage during pregnancy or delivery as a forgotten exposure towards understanding some of the challenges in achieving Sustainable Development Goal 3.

Methods

This cross-sectional quantitative study gathered information from women who delivered a live-born baby in the preceding two years. Using a two-stage-sampling technique, women attending reproductive, maternal and child health clinics in Tabora were selected and interviewed. Proportions were compared using chi-square test and Poisson regression analysis was performed to determine independent correlates of herbal medicine use.

Results

Of 340 recruited women, 208 [61.2 %; 95 % confidence interval: 55.4, 66.3 %] used herbal medicines during pregnancy or delivery. Major reasons for use included accelerating labour, 81 (38.9 %) and reducing labour pains, 58 (27.9 %). Women who made less than four antenatal visits had a 24 % higher adjusted prevalence ratio of using herbal medicines as compared to those who had at least four visits [adjusted prevalence ratio:1.24; 95 % confidence interval: 1.02, 1.50, p = 0.03]. Furthermore, the adjusted prevalence ratio of using herbal medicines was 35 % higher among women who were not discouraged by health care providers against their use as compared to those who were discouraged (adjusted prevalence ratio: 1.35; 95 % confidence interval: 1.13, 1.60, p = 0.01).

Conclusions

Use of herbal medicines during pregnancy or delivery among women in Tanzania is common. Independent predictors of herbal medicine use were number of antenatal visits and stance of maternity health care providers on their use. Comprehensive investigations on the magnitude, patterns and predictors of use of herbal medicines during pregnancy or delivery are warranted.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12884-021-03741-5.

Non-prescribed drug use and predictors among pregnant women in Ethiopia: systematic review and meta-analysis

BACKGROUND

The use of non-prescribed drugs are common to pregnant women. It may lead to undesirable effects, such as birth defects. Study results on the occurrence and predictor of non-prescribed drug use among pregnant women throughout Ethiopia are highly variable and inconsistent. Therefore, the objective of this systematic review and meta-analysis was to estimate the pooled prevalence of non-prescribed drug use and predictors among pregnant women in Ethiopia.

METHODS

We systematically searched studies from the international databases, including PubMed, EMBASE, Web of Science, Science Direct, Google Scholar, the Cochrane Library and others. The meta-analysis was conducted using Stata15. I² test and Egger's test were used to assess the heterogeneity and publication bias respectively. The random-effect model was used to estimate the pooled prevalence of non-prescribed drug use at a 95% CI.

RESULTS

Eleven studies with a total of 4492 pregnant women fulfilled the inclusion criteria and were included. The pooled national level non-prescribed drug use among pregnant women was 30.38% (95% CI: 20.28, 40.48). The highest use of non-prescribed drug among pregnant women was observed in Amhara region 36.71%, while the lowest was in Tigray region 9.67%, respectively. The most frequently consumed non prescribed drugs by pregnant mothers were paracetamol 34.38%, amoxicillin 14.73%, aspirin 4.25%, metronidazole 2.81% and ciprofloxacin 2.80%. Maternal previous history of self-medication, maternal illness during pregnancy and maternal marital status were significantly associated with women non-prescribed drug use during pregnancy.

CONCLUSIONS

The overall prevalence of non- prescribed drug use among pregnant women in Ethiopia is relatively high, and varies across different regions. The most frequently consumed non- prescribed drug by pregnant mothers was paracetamol. Maternal; previous history of self-medication, illness during pregnancy and marital status were significantly associated with pregnant women non-prescribed drug use. Awareness of the possible side effects of taking non-prescribed drugs for all pregnant women is very relevant in the media and in the maternity ward. In particular, it is important to make clear to mothers who have a history of self-medication, to those who have a history of illness during pregnancy and to those who are pregnant, unmarried or divorced.

Herbal Medicine Use During Pregnancy: A Review of the Literature With a Special Focus on Sub-Saharan Africa

Herbal medicine use has grown considerably worldwide among pregnant women, and is particularly widespread in sub-Saharan Africa. However, herbal medicines used across sub-Saharan Africa are associated with important research gaps and a lack of regulatory framework. This is particularly problematic, as herbal medicine use during pregnancy raises several concerns attributed to the herbal ingredient itself, conventional drug-herbal medicine interactions, and contamination or adulteration of herbal remedies. Moreover, several local herbal remedies used by sub-Saharan African pregnant women have never been botanically identified. In this review, an overview of the practice of herbal medicine, including the regulations, challenges and overall safety, is provided. Then, we discuss the prevalence of herbal medicine use during pregnancy across different sub-Saharan African countries, as well as the indications, adverse outcomes, and effectiveness of the most commonly used herbal medicines during pregnancy in that region.

Self-Medication and Associated Factors Among Pregnant Women Attending Antenatal Care at Kemisie General Hospital, North East Ethiopia

INTRODUCTION

Self-medication is an important part of daily self-care, without the supervision of health professionals. It is commonly practiced by pregnant women all over the world and may result in maternal and fetal risks. Hence, this study assessed self-medication practices and associated factors among pregnant women attending Kemisie General Hospital.

METHODS

A facility-based cross-sectional study was conducted using a structured questionnaire on pregnant women who were attending antenatal care at Kemisie General Hospital. A simple random sampling technique was employed to select the study participants. Descriptive and inferential statistics were computed using the Statistical Package for Social Sciences version 20.

RESULTS

Among 223 pregnant women, 60 (26.9%; 95% CI: 20.9%, 32.9%) and 111 (48.9%; 95% CI: 43%, 58%) practiced self-medication on conventional and herbal medicine, respectively. The predictors of self-medication of conventional medicine among pregnant women were prior experience to the drug (P-value: 0.00, AOR=126.04, 95% CI: 32.55-488.04) and no pervious history of abortion (P-value: 0.00, AOR=0.01,95% CI:0.002-0.04), while college educational level (P-value: 0.00, AOR=13.45,95%, CI: 3.58-50.5), history prior herbal medicine use (P-value: 0.00, AOR=9, 95% CI: 3.32-24.39), Ruta chalepensis (P-value:0.001,AOR=193.7,95% CI:8.64-4342.1) and Ocimum lamiifolium type of herb use (P-value: 0.004, AOR=12.72, 95% CI: 2.27-71.38), and 5-10km health facility distance (P-value:0.022, AOR=0.1, 95% CI: 0.01-0.73) were predictors for self-medication practice of herbal medicines among pregnant women.

CONCLUSION

Nearly one-third and two-third of pregnant women practiced self-medication on conventional and herbal medicine, respectively. Prior experience to the drug and no previous history of abortion associated with self-medication of conventional medicine, while college educational level, history prior herbal medicine use, Ruta chalepensis and, Ocimum lamiifolium type of herb use, and 5-10km distance were predictors for self-medication practice of herbal medicines. Improving health service coverage and awareness creation on rational medication use is recommended to prevent fetal and maternal risks.