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Kiiza D, Rostami-Hochaghan D, Alhassan Y, Seden K, Reynolds H, Kaboggoza JP, Taegtmeyer M, Chen T, Challenger E, Malaba T, Wang D, Else L, Hern F, Sharp J, Neary M, Dilly Penchala S, Waitt C, Orrell C, Colbers A, Myer L, Owen A, Rannard S, Khoo S, Lamorde M. Clinical, pharmacological, and qualitative characterization of drug-drug interactions in pregnant women initiating HIV therapy in Sub-Saharan Africa. J Antimicrob Chemother 2024:dkae232. [PMID: 38997229 DOI: 10.1093/jac/dkae232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 06/22/2024] [Indexed: 07/14/2024] Open
Abstract
BACKGROUND We investigated the impact of Drug-Drug Interactions (DDIs) on virologic control among HIV-positive pregnant women initiating antiretroviral therapy while identifying drivers for Traditional Medicine (TM) use and exploring the nature and extent of TM-related DDIs. METHODS Employing a three-pronged approach, we examined DDIs arising from comedication, including TM, in ART. The DolPHIN-2 trial (NCT03249181) randomized 268 HIV-positive pregnant women in Uganda and South Africa to dolutegravir (DTG)-based (135) or efavirenz-based (133) regimens while systematically recording comedications and screening for DDIs. We used Cox regression models to compare time-to-virologic control between participants with and without DDIs. We conducted in-depth interviews and focus group discussions among 37 and 67 women with and without HIV, respectively, to explore reasons for TM use during pregnancy. Additionally, in-vitro and in-vivo studies evaluated the composition and impact of clay-based TM, mumbwa, on DTG plasma exposure. RESULTS The baseline prevalence of DDIs was 67.2%, with TM use prevalent in 34% of participants, with mumbwa being the most frequent (76%, 69/91). There was no difference in virologic response between participants with and without DDIs. Fetal health and cultural norms were among the reasons cited for TM use. Analysis of mumbwa rods confirmed significant amounts of aluminium (8.4%-13.9%) and iron (4%-6%). In Balb-C mice, coadministration of mumbwa led to a reduction in DTG exposure observed in the AUC0-24 (-21%; P = 0.0271) and C24 (-53%; P = 0.0028). CONCLUSIONS The widespread use of clay-based TM may compromise HIV treatment, necessitating medication screening and counselling to manage DDIs in pregnant women.
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Affiliation(s)
- Daniel Kiiza
- Research Department, Infectious Diseases Institute, College of Health Sciences, Makerere University, Kampala, Uganda
| | | | - Yussif Alhassan
- Department of International Public Health, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Kay Seden
- Department of Pharmacology and Therapeutics, University of Liverpool, Liverpool, UK
| | - Helen Reynolds
- Department of Pharmacology and Therapeutics, University of Liverpool, Liverpool, UK
| | - Julian P Kaboggoza
- Research Department, Infectious Diseases Institute, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Miriam Taegtmeyer
- Department of International Public Health, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Tao Chen
- Department of International Public Health, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Elizabeth Challenger
- Department of Pharmacology and Therapeutics, University of Liverpool, Liverpool, UK
| | - Thokozile Malaba
- Division of Epidemiology and Biostatistics, School of Public Health, University of Cape Town, Cape Town, South Africa
| | - Duolao Wang
- Department of International Public Health, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Laura Else
- Department of Pharmacology and Therapeutics, University of Liverpool, Liverpool, UK
| | - Faye Hern
- Department of Chemistry, University of Liverpool, Liverpool, UK
| | - Jo Sharp
- Department of Pharmacology and Therapeutics, University of Liverpool, Liverpool, UK
| | - Megan Neary
- Department of Pharmacology and Therapeutics, University of Liverpool, Liverpool, UK
| | - Sujan Dilly Penchala
- Department of Pharmacology and Therapeutics, University of Liverpool, Liverpool, UK
| | - Catriona Waitt
- Research Department, Infectious Diseases Institute, College of Health Sciences, Makerere University, Kampala, Uganda
- Department of Pharmacology and Therapeutics, University of Liverpool, Liverpool, UK
| | - Catherine Orrell
- Desmond Tutu HIV Centre, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa
| | - Angela Colbers
- Department of Pharmacy, Radboud Institute for Medical Innovations (RIMI), Radboud University Medical Center, Nijmegen, Netherlands
| | - Landon Myer
- Department of International Public Health, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Andrew Owen
- Department of Pharmacology and Therapeutics, University of Liverpool, Liverpool, UK
| | - Steve Rannard
- Department of Chemistry, University of Liverpool, Liverpool, UK
| | - Saye Khoo
- Department of Pharmacology and Therapeutics, University of Liverpool, Liverpool, UK
- Royal Liverpool University Hospital, NHS Trust, UK
| | - Mohammed Lamorde
- Research Department, Infectious Diseases Institute, College of Health Sciences, Makerere University, Kampala, Uganda
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Fobo KN, Kovane GP, Minnie CS. Management of the third stage of labour by Basotho traditional birth attendants. Health SA 2024; 29:2372. [PMID: 38628238 PMCID: PMC11019081 DOI: 10.4102/hsag.v29i0.2372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Accepted: 10/11/2023] [Indexed: 04/19/2024] Open
Abstract
Background Historically and to date, women still give birth at home with the support of elderly, experienced women who live within their communities. In Lesotho, traditional birth attendants (TBAs) are sometimes the only option for pregnant women living far from facilities. Women are vulnerable during the third stage of labour; therefore, correct management is crucial to limit undesirable outcomes. Postpartum haemorrhage and postpartum sepsis remain the leading direct causes of maternal mortality. Aim This study aimed to explore and describe how Basotho TBAs manage the third stage of labour. Setting The study was conducted in Lesotho, at Bolahla and Sejakhosi. These villages have the highest number of women giving birth at home. Methods An explorative and descriptive design with a qualitative approach was used. Semistructured interview guide was utilised to conduct individual in-depth interviews about how the TBAs manage the third stage of labour and their support needs concerning this phase. The TBAs were purposively sampled. The data were analysed thematically. Results Four themes emerged: challenges TBA experience in the management of the third stage of labour, management of the placenta by Basotho traditional birth attendants, support during the management of the placenta by Basotho traditional birth attendants, and management during emergencies. Conclusion This study demonstrated that if TBAs are supported, they can contribute to the health of the mother and baby. Contribution This study's findings can be valuable to healthcare professionals to understand better how TBAs in Lesotho manage the third stage of labour and the support they need.
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Affiliation(s)
- Keneuoe N Fobo
- School of Nursing, Faculty of Health Sciences, North-West University, Potchefstroom, South Africa
| | - Gaotswake P Kovane
- School of Nursing, Faculty of Health Sciences, North-West University, Mafikeng, South Africa
| | - Catharina S Minnie
- School of Nursing, Faculty of Health Sciences, University of the Western Cape, Cape Town, South Africa
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Gülpınar G, Uzun MB, Iqbal A, Anderson C, Syed W, Al-Rawi MBA. A model of purchase intention of complementary and alternative medicines: the role of social media influencers' endorsements. BMC Complement Med Ther 2023; 23:439. [PMID: 38053060 PMCID: PMC10696731 DOI: 10.1186/s12906-023-04285-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 11/29/2023] [Indexed: 12/07/2023] Open
Abstract
BACKGROUND Social Media Influencers (SMIs) are a fashionable way of marketing products by creating electronic word-of-mouth (e-WOM) on social media. The marketing of complementary and alternative medicines (CAMs) by SMIs is becoming increasingly popular and gaining credibility within consumers on social media platforms. Nonetheless, advising about healthcare products on social media should be examined as it is different from endorsing other kinds of commercial products. The aim of this study is to develop a model that provides the underlying mechanisms of the stimuli of SMIs on social media towards consumers' purchase intention of CAMs. METHODS This study used best fit framework synthesis methods to develop the model. A priori theory selection was conducted by identifying a BeHEMoTh strategy (Behavior of Interest, Health context, Exclusions and Models or Theories) to systematically approach identifying relevant models and theories relative to the research aim. Further evidence derived from primary research studies that describe the behavior identified is coded against selected a priori theory to develop the model. RESULTS This study presents a novel model for understanding the purchase behavior of CAMs using SMIs as a marketing strategy. The model included two well-known theories (theory of planned behaviour theory and source credibility theory) as well as extensive existing research from a multidisciplinary perspective. The model is exclusively designed to help identify elements affecting perceived source credibility and factors that have an influence over consumers' preferences to purchase CAMs by taking into consideration SMIs' endorsements. CONCLUSIONS This study provides unique insights introducing new research areas to health literature and offers, new roles for healthcare professionals in this digital era by gaining new skills and competencies required to provide more credible and accurate information about CAMs. The study also highlights the new marketing era of online health-related product endorsements and recommends that policymakers and researchers carefully evaluate the impact of SMI's on the use of CAMs, as well as to regulate the content of these promotional materials.
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Affiliation(s)
- Gizem Gülpınar
- Department of Pharmacy Management, Faculty of Pharmacy, Gazi University, 06330, Ankara, Turkey
| | - Mehmet Barlas Uzun
- Department of Pharmacy Management, Faculty of Gülhane Pharmacy, Sağlık Bilimleri University, 06018, Ankara, Turkey
| | - Ayesha Iqbal
- Division of Pharmacy Practice and Policy, School of Pharmacy, University of Nottingham, Nottingham, NG7 2RD, UK.
- Office of Lifelong Learning and the Physician Learning Program, Faculty of Medicine and Dentistry, University of Alberta, T6G1C9, Edmonton, AB, Canada.
| | - Claire Anderson
- Division of Pharmacy Practice and Policy, School of Pharmacy, University of Nottingham, Nottingham, NG7 2RD, UK
| | - Wajid Syed
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia.
| | - Mahmood Basil A Al-Rawi
- Department of Optometry, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
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Jiménez-Osorio AS, Carreón-Torres E, Correa-Solís E, Ángel-García J, Arias-Rico J, Jiménez-Garza O, Morales-Castillejos L, Díaz-Zuleta HA, Baltazar-Tellez RM, Sánchez-Padilla ML, Flores-Chávez OR, Estrada-Luna D. Inflammation and Oxidative Stress Induced by Obesity, Gestational Diabetes, and Preeclampsia in Pregnancy: Role of High-Density Lipoproteins as Vectors for Bioactive Compounds. Antioxidants (Basel) 2023; 12:1894. [PMID: 37891973 PMCID: PMC10604737 DOI: 10.3390/antiox12101894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 10/05/2023] [Accepted: 10/13/2023] [Indexed: 10/29/2023] Open
Abstract
Inflammation and oxidative stress are essential components in a myriad of pathogenic entities that lead to metabolic and chronic diseases. Moreover, inflammation in its different phases is necessary for the initiation and maintenance of a healthy pregnancy. Therefore, an equilibrium between a necessary/pathologic level of inflammation and oxidative stress during pregnancy is needed to avoid disease development. High-density lipoproteins (HDL) are important for a healthy pregnancy and a good neonatal outcome. Their role in fetal development during challenging situations is vital for maintaining the equilibrium. However, in certain conditions, such as obesity, diabetes, and other cardiovascular diseases, it has been observed that HDL loses its protective properties, becoming dysfunctional. Bioactive compounds have been widely studied as mediators of inflammation and oxidative stress in different diseases, but their mechanisms of action are still unknown. Nonetheless, these agents, which are obtained from functional foods, increase the concentration of HDL, TRC, and antioxidant activity. Therefore, this review first summarizes several mechanisms of HDL participation in the equilibrium between inflammation and oxidative stress. Second, it gives an insight into how HDL may act as a vector for bioactive compounds. Third, it describes the relationships between the inflammation process in pregnancy and HDL activity. Consequently, different databases were used, including MEDLINE, PubMed, and Scopus, where scientific articles published in the English language up to 2023 were identified.
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Affiliation(s)
- Angélica Saraí Jiménez-Osorio
- Área Académica de Enfermería, Instituto de Ciencias de la Salud, Universidad Autónoma del Estado Hida go, Circuito Ex Hacienda La Concepción S/N, Carretera Pachuca-Actopan, San Agustín Tlaxiaca 42160, Hidalgo, Mexico; (A.S.J.-O.); (J.Á.-G.); (J.A.-R.); (O.J.-G.); (L.M.-C.); (R.M.B.-T.); (M.L.S.-P.); (O.R.F.-C.)
| | - Elizabeth Carreón-Torres
- Department of Molecular Biology, Instituto Nacional de Cardiología “Ignacio Chávez”, Juan Badiano 1, Sección XVI, Tlalpan, Mexico City 14080, Mexico;
| | - Emmanuel Correa-Solís
- Instituto de Farmacobiología, Universidad de la Cañada, Carretera Teotitlán-San Antonio Nanahuatipán Km 1.7 s/n., Paraje Titlacuatitla, Teotitlán de Flores Magón 68540, Oaxaca, Mexico;
| | - Julieta Ángel-García
- Área Académica de Enfermería, Instituto de Ciencias de la Salud, Universidad Autónoma del Estado Hida go, Circuito Ex Hacienda La Concepción S/N, Carretera Pachuca-Actopan, San Agustín Tlaxiaca 42160, Hidalgo, Mexico; (A.S.J.-O.); (J.Á.-G.); (J.A.-R.); (O.J.-G.); (L.M.-C.); (R.M.B.-T.); (M.L.S.-P.); (O.R.F.-C.)
| | - José Arias-Rico
- Área Académica de Enfermería, Instituto de Ciencias de la Salud, Universidad Autónoma del Estado Hida go, Circuito Ex Hacienda La Concepción S/N, Carretera Pachuca-Actopan, San Agustín Tlaxiaca 42160, Hidalgo, Mexico; (A.S.J.-O.); (J.Á.-G.); (J.A.-R.); (O.J.-G.); (L.M.-C.); (R.M.B.-T.); (M.L.S.-P.); (O.R.F.-C.)
| | - Octavio Jiménez-Garza
- Área Académica de Enfermería, Instituto de Ciencias de la Salud, Universidad Autónoma del Estado Hida go, Circuito Ex Hacienda La Concepción S/N, Carretera Pachuca-Actopan, San Agustín Tlaxiaca 42160, Hidalgo, Mexico; (A.S.J.-O.); (J.Á.-G.); (J.A.-R.); (O.J.-G.); (L.M.-C.); (R.M.B.-T.); (M.L.S.-P.); (O.R.F.-C.)
| | - Lizbeth Morales-Castillejos
- Área Académica de Enfermería, Instituto de Ciencias de la Salud, Universidad Autónoma del Estado Hida go, Circuito Ex Hacienda La Concepción S/N, Carretera Pachuca-Actopan, San Agustín Tlaxiaca 42160, Hidalgo, Mexico; (A.S.J.-O.); (J.Á.-G.); (J.A.-R.); (O.J.-G.); (L.M.-C.); (R.M.B.-T.); (M.L.S.-P.); (O.R.F.-C.)
| | - Hugo Alexander Díaz-Zuleta
- Facultad de Ciencias de la Salud, Universidad de Ciencias Aplicadas y Ambientales, Cl. 222 #54-21, Bogotá 111166, Colombia;
| | - Rosa María Baltazar-Tellez
- Área Académica de Enfermería, Instituto de Ciencias de la Salud, Universidad Autónoma del Estado Hida go, Circuito Ex Hacienda La Concepción S/N, Carretera Pachuca-Actopan, San Agustín Tlaxiaca 42160, Hidalgo, Mexico; (A.S.J.-O.); (J.Á.-G.); (J.A.-R.); (O.J.-G.); (L.M.-C.); (R.M.B.-T.); (M.L.S.-P.); (O.R.F.-C.)
| | - María Luisa Sánchez-Padilla
- Área Académica de Enfermería, Instituto de Ciencias de la Salud, Universidad Autónoma del Estado Hida go, Circuito Ex Hacienda La Concepción S/N, Carretera Pachuca-Actopan, San Agustín Tlaxiaca 42160, Hidalgo, Mexico; (A.S.J.-O.); (J.Á.-G.); (J.A.-R.); (O.J.-G.); (L.M.-C.); (R.M.B.-T.); (M.L.S.-P.); (O.R.F.-C.)
| | - Olga Rocío Flores-Chávez
- Área Académica de Enfermería, Instituto de Ciencias de la Salud, Universidad Autónoma del Estado Hida go, Circuito Ex Hacienda La Concepción S/N, Carretera Pachuca-Actopan, San Agustín Tlaxiaca 42160, Hidalgo, Mexico; (A.S.J.-O.); (J.Á.-G.); (J.A.-R.); (O.J.-G.); (L.M.-C.); (R.M.B.-T.); (M.L.S.-P.); (O.R.F.-C.)
| | - Diego Estrada-Luna
- Área Académica de Enfermería, Instituto de Ciencias de la Salud, Universidad Autónoma del Estado Hida go, Circuito Ex Hacienda La Concepción S/N, Carretera Pachuca-Actopan, San Agustín Tlaxiaca 42160, Hidalgo, Mexico; (A.S.J.-O.); (J.Á.-G.); (J.A.-R.); (O.J.-G.); (L.M.-C.); (R.M.B.-T.); (M.L.S.-P.); (O.R.F.-C.)
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Hailu M, Mohammed A, Sintayehu Y, Tadesse D, Abera L, Abdurashid N, Solomon M, Ali M, Mellese D, Weldeamaniel T, Mengesha T, Hailemariyam T, Amsalu S, Dejene Y, Girma M. Cultural malpractice during pregnancy, childbirth, and the postnatal period and its associated factors among women who gave birth once in Dire Dawa city administration, Eastern Ethiopia, in 2021. Front Glob Womens Health 2023; 4:1131626. [PMID: 37664420 PMCID: PMC10469776 DOI: 10.3389/fgwh.2023.1131626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2022] [Accepted: 07/31/2023] [Indexed: 09/05/2023] Open
Abstract
Background Cultural practices are any experiences or beliefs that are socially shared views and behaviors practiced in a certain society at a certain time. Cultural malpractices are defined as socially shared views and traditionally accepted behaviors experienced in a certain society that harm maternal health. Worldwide, the period of pregnancy, labor, and delivery is embedded with different beliefs, customs, and rituals in different societies that contribute a lot to maternal death. They are responsible for the annual deaths of 303,000 mothers and 2.7 million newborns globally. In developing countries, it accounts for approximately 5%-15% of maternal deaths. In Ethiopia, approximately 18% of infant deaths occur due to cultural malpractice, and 52% of pregnant mothers give birth at home following cultural customs in Dire Dawa city. The objective of this study was to assess cultural malpractices during pregnancy, childbirth, and the postnatal period and its associated factors among women who gave birth once in Dire Dawa City in 2021. Methods Community-based mixed study was conducted. A total of 624 study participants were selected through a systematic random sampling technique, and a purposive sampling method was used for qualitative data. The study was conducted in the randomly selected Kebeles of Dire Dawa City, Eastern Ethiopia, from November 1 to December 30, 2021. Data were entered into Epi Data version 4.1 and exported to SPSS version 24 for analysis. Bivariate and multivariate analyses were done, and the degree of association was measured by using the odds ratio with 95% CI and significance was declared at a p-value of <0.05. The qualitative data were analyzed thematically using ATLAS-ti version 7. Results The overall prevalence of cultural malpractice during pregnancy, childbirth, and the postnatal period was 74.6% [95% CI: 70.59%, 77.49%]. Women over the age of 35 were two times more likely [AOR 2.61, 95% CI, 1.45-4.72] to commit cultural malpractice than women aged 15-24 and 25-34. Those with no antenatal care (ANC) follow-up were three times more likely to commit cultural malpractice [AOR 3.57, 95% CI, 1.72-7.40], those who were absent from health education were nearly two times more likely to commit cultural malpractice [AOR 1.83, 95%CI, 1.25-2.67], and women whose culture allows harmful traditional practices were nearly two times more likely to commit cultural malpractices than their counterparts [AOR 1.69, 95%CI, 1.29-2.54]. Conclusion In this study, nearly three-fourths of participants were involved in cultural malpractices. Therefore, strengthening community education and behavioral change messages on the importance of ANC and avoiding unhealthy care during pregnancy, childbirth, postnatal and neonatal periods, especially with pregnancy at old age (age > 35), may help to reduce cultural malpractices.
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Affiliation(s)
- Mickiale Hailu
- College of Medicine and Health Sciences, Dire Dawa University, Dire Dawa, Ethiopia
| | - Aminu Mohammed
- College of Medicine and Health Sciences, Dire Dawa University, Dire Dawa, Ethiopia
| | - Yitagesu Sintayehu
- College of Medicine and Health Sciences, Dire Dawa University, Dire Dawa, Ethiopia
| | - Daniel Tadesse
- College of Medicine and Health Sciences, Dire Dawa University, Dire Dawa, Ethiopia
| | - Legesse Abera
- College of Medicine and Health Sciences, Dire Dawa University, Dire Dawa, Ethiopia
| | - Neil Abdurashid
- College of Medicine and Health Sciences, Dire Dawa University, Dire Dawa, Ethiopia
| | - Milkiyas Solomon
- College of Medicine and Health Sciences, Dire Dawa University, Dire Dawa, Ethiopia
| | - Momina Ali
- College of Medicine and Health Sciences, Dire Dawa University, Dire Dawa, Ethiopia
| | - Dawit Mellese
- College of Medicine and Health Sciences, Dire Dawa University, Dire Dawa, Ethiopia
| | - Tadesse Weldeamaniel
- College of Medicine and Health Sciences, Dire Dawa University, Dire Dawa, Ethiopia
| | - Teshale Mengesha
- College of Medicine and Health Sciences, Dire Dawa University, Dire Dawa, Ethiopia
| | | | - Sewmehon Amsalu
- College of Medicine and Health Sciences, Dire Dawa University, Dire Dawa, Ethiopia
| | - Yesuneh Dejene
- College of Health Sciences, Wachemo University, Hossana, Ethiopia
| | - Meklit Girma
- College of Health Sciences, Mekelle University, Mekelle, Ethiopia
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Suh Nchang A, Njong S, Noukimi SF, Shinyuy LM, Bambara S, Kalimba EM, Kamga J, Souopgui J, Ghogomu SM, Frederich M, Talom JLL, Robert A. A cross-sectional survey on the use of herbal tea among Cameroonian adults (18-65 years). BMC Complement Med Ther 2023; 23:285. [PMID: 37568232 PMCID: PMC10422798 DOI: 10.1186/s12906-023-04040-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 06/14/2023] [Indexed: 08/13/2023] Open
Abstract
BACKGROUND In respect of the WHO's commendation to incorporate traditional medicine (TM) in health care, the Cameroon government wants to promote the use of the traditional medicine and is resolute on encouraging the treatment of patients with alternative medicine from traditional sources. This study explores the use of herbal tea by Cameroonian adults to prevent or treat diseases and the socio-demographic determinants of tea use among participants. METHODS A cross-sectional survey was conducted among 307 Cameroonian adults (18-65 years) randomly selected within 4 hospitals and 4 communities in the Centre and Southwest regions of Cameroon between 04/01-20/04/2022, using interviewer administered semi-structured questionnaires. Binary logistic regression analysis was conducted to determine the association between variables. RESULTS Over four-fifth (89.3%) of participants had taken herbal teas at least once within the last 2 years prior to the survey, and most participants used the teas for the prevention and treatment of Covid-19 (67.9%), malaria (59.7%) and typhoid fever (35%). Most respondents took the teas warm (75%), and the treatment dosage used by most respondents (51%) was "one glass in the morning and evening for one to two weeks". The teas taken by 70% of users had bad or bitter taste and 52.2% of them were uncomfortable with the bad taste. However, the majority of users completed their treatment dosage (72%), 90.5% of them were willing to use teas for treatment if prescribed in health facilities in future, and 90.1% were in support that herbal teas should be prescribed in hospitals. There was no significant association (p ≥ 0.05) between sociodemographic characteristics of participants and herbal tea use. However, the major motivating factor for acceptability of herbal tea use was treatment effectiveness (52.7%). CONCLUSION There is high prevalence of herbal tea use among adults Cameroonians in the studied settings in the Centre and Southwest regions of Cameroon, with a positive opinion and willingness to use teas if prescribed in health facilities. Authorities must ensure the effectiveness and safety of traditional medicine served in health facilities, to enhance compliance and adequate use.
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Affiliation(s)
- Abenwie Suh Nchang
- Department of Epidemiology and Biostatistics (EPID, Institute de Recherche Exprimentale Et Clinique (IREC), Université Catholique de Louvain (UCLouvain), Public Health School, Brussels, Belgium.
| | - Sylvia Njong
- Department of Epidemiology and Biostatistics (EPID, Institute de Recherche Exprimentale Et Clinique (IREC), Université Catholique de Louvain (UCLouvain), Public Health School, Brussels, Belgium
| | | | - Lahngong Methodius Shinyuy
- Laboratory of Pharmacognosy, Department of Pharmacy, Center of Interdisciplinary Research On Medicine (CIRM), University of Liege, Liège, Belgium
| | - Sylvie Bambara
- Department of Epidemiology and Biostatistics (EPID, Institute de Recherche Exprimentale Et Clinique (IREC), Université Catholique de Louvain (UCLouvain), Public Health School, Brussels, Belgium
| | | | - Joseph Kamga
- Biotechnology Unit, University of Buea, Buea, Cameroon
| | - Jacob Souopgui
- Embriology and Biotechnology Laboratory, IBMM-ULB, Brussels, Belgium
| | | | - Michel Frederich
- Laboratory of Pharmacognosy, Department of Pharmacy, Center of Interdisciplinary Research On Medicine (CIRM), University of Liege, Liège, Belgium
| | | | - Annie Robert
- Department of Epidemiology and Biostatistics (EPID, Institute de Recherche Exprimentale Et Clinique (IREC), Université Catholique de Louvain (UCLouvain), Public Health School, Brussels, Belgium
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Ahmed GEM, Ahmed EYM, Ahmed AE, Hemmeda L, Birier AB, Abdelgadir T, Hassan HMA, Alfadul ESA, Bakr M, Sadig E. Prevalence and reasons to seek traditional healing methods among residents of two localities in North Kordofan State, Sudan 2022: A cross-sectional study. Health Sci Rep 2023; 6:e1487. [PMID: 37621385 PMCID: PMC10444970 DOI: 10.1002/hsr2.1487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 07/22/2023] [Accepted: 07/27/2023] [Indexed: 08/26/2023] Open
Abstract
Background and Aims Traditional medicines are one of Africa's primary response mechanisms to medical emergencies, while, in other communities, all healthcare decisions are based on indigenous traditions and beliefs. For millions of individuals who reside in rural areas throughout low- and middle-income nations, those healers serve as their only primary healthcare practitioners. This study intends to examine the availability, preferences, and practices of traditional medicine seeking among the Sudanese of North Kordofan state. Method A descriptive cross-sectional study was carried out in two conveniently chosen localities in North Kordofan state, namely Barrah, and Shaikan. A structured questionnaire with three sections-sociodemographic, attitudes, and forms of traditional medical practices-was used for face-to-face interviews with the residents. The frequency (n) and percentage (%) of categorical data are presented. The Chi-square and Fischer exact tests were performed to determine characteristics related to traditional medicine practice and the preferred type of medicine among participants; a p value of.05 was considered significant. Results A total of 302 residents took part in the study, with the 15-30 age group constituting the majority. The majority of participants (89.1%) used traditional medicine, and the majority of them (92.4%) learned about it from their families. The major type of traditional medicine (60.3%) used was a medical herbs-herb practitioner. Cultural influences (57%) and the effectiveness of traditional medicines (48.3%) were the most common reasons for seeking those medicines. Conclusion Most participants seek traditional medicine, with traditional herbs and holy recitation commonly used. Affordability, therapeutic effectiveness, and cultural and religious influence were reasons for preferring traditional medicine.
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Affiliation(s)
| | | | | | - Lina Hemmeda
- Faculty of MedicineUniversity of KhartoumKhartoumSudan
| | | | | | | | | | - Musab Bakr
- Faculty of MedicineUniversity of KhartoumKhartoumSudan
| | - Ethar Sadig
- Faculty of MedicineUniversity of KhartoumKhartoumSudan
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8
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Amoak D, Dhillon S, Antabe R, Sano Y, Luginaah I. Factors Associated with Deworming Medication Utilization among Pregnant Women in Benin: Evidence from the Demographic and Health Survey. Trop Med Infect Dis 2023; 8:tropicalmed8030166. [PMID: 36977167 PMCID: PMC10053996 DOI: 10.3390/tropicalmed8030166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 03/01/2023] [Accepted: 03/10/2023] [Indexed: 03/16/2023] Open
Abstract
Deworming medication utilization is a useful strategy to reduce the burden of anemia among pregnant women. Yet, we know very little about the prevalence and correlates of deworming medication utilization among pregnant women in sub-Saharan Africa, including Benin. To address this void in the literature, we used the 2017–2018 Benin Demographic and Health Survey and applied logistic regression analysis to explore the demographic, socioeconomic, and healthcare factors associated with deworming medication utilization in Benin. We found that deworming medication coverage was 65% at the national level. We observed that women aged 35–49 years were less likely to use deworming medication compared to those aged 15–24 years (OR = 0.79, p < 0.01). Compared to Christian women, Muslim women (OR = 0.70, p < 0.01) and women of other religions (OR = 0.51, p < 0.01) were also less likely to use deworming medication. Moreover, women with lower levels of education and household wealth, as well as unemployed women, were less likely to use deworming medication in comparison to their educated, richer, and employed counterparts. Women who visited ANC fewer than eight times were also less likely to use deworming medication compared to their counterparts who did so eight times or more (OR = 0.65, p < 0.001). Based on these findings, we discussed several implications for policymakers.
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Affiliation(s)
- Daniel Amoak
- Department of Geography and Environment, Western University, London, ON N6A 5C2, Canada
| | - Satveer Dhillon
- Department of Geography and Environment, Western University, London, ON N6A 5C2, Canada
| | - Roger Antabe
- Department of Health and Society, University of Toronto Scarborough, Scarborough, ON M1C 1A4, Canada
| | - Yujiro Sano
- Department of Sociology and Anthropology, Nipissing University, North Bay, ON P1B 8L7, Canada
- Correspondence:
| | - Isaac Luginaah
- Department of Geography and Environment, Western University, London, ON N6A 5C2, Canada
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9
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Baakeleng BG, Pienaar AJ, Sithole PM, Mashego SL. Indigenous practitioners' views on causes of female infertility. Health SA 2023; 28:2152. [PMID: 36873780 PMCID: PMC9982502 DOI: 10.4102/hsag.v28i0.2152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Accepted: 12/06/2022] [Indexed: 02/05/2023] Open
Abstract
Background The use of indigenous practices has increased remarkably throughout the world. Subsequently, society uses this practice for the treatment of various health problems, including infertility. This research focussed on the role of indigenous practitioners (IPs) using a holistic approach to explore the causes of infertility in women. Aim This study aimed to explore and describe the views of IPs on the causes of female infertility in Ngaka Modiri Molema health district. Setting The study was conducted in Ngaka Modiri Molema, North West Province, one of the most rural provinces in South Africa. Methods The study followed a qualitative explorative design. A purposive sampling technique identified five IPs who were experts in managing infertility. Individual semi-structured interviews were conducted, and data analysis used Creswell's method of qualitative data analysis. Results Findings revealed that IPs offered a wide range of services in the treatment and management of infertility among rural women. Hence, the following themes emerged, namely, history taking regarding infertility, treatment of infertility and holistic care on infertility. Conclusion The IPs are important providers of healthcare in the management of infertility in indigenous communities. The findings revealed that there are various causes of female infertility according to the indigenous healthcare system. Contribution In contribution, the study described the unique practices found in the community as executed by the IPs. This care focusses on holistic care, including treatment and continuous care for the healthcare user and the family. Noteworthy to mention, this holistic care extends to subsequent pregnancies. However, there is a need for further research to valorise the indigenous knowledge unearthed in this study.
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Affiliation(s)
- Banabotlhe G Baakeleng
- School of Nursing, Faculty of Health Sciences, North-West University, Mafikeng, South Africa
| | - Abel J Pienaar
- Department of Nursing, Faculty of Nursing and Midwifery, Shifa Tameer-Millat University, Islamabad, Pakistan.,Department of Nursing, Faculty of Nursing and Midwifery, University of Venda, Thohoyandou, South Africa
| | - Puledi M Sithole
- School of Nursing, Faculty of Health Sciences, North-West University, Mafikeng, South Africa
| | - Simangaliso L Mashego
- Indigenous Knowledge System Centre, Faculty of Agriculture and Natural Science, North-West University, Mafikeng, South Africa
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10
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Kateera F, Hedt-Gauthier B, Luo A, Niyigena A, Galvin G, Hakizimana S, Molina RL, Boatin AA, Kasonde P, Musabeyezu J, Ngonzi J, Riviello R, Semrau K, Sayinzoga F. Safe recovery after cesarean in rural Africa: Technical consensus guidelines for post-discharge care. Int J Gynaecol Obstet 2023; 160:12-21. [PMID: 35617096 PMCID: PMC10083957 DOI: 10.1002/ijgo.14284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 05/06/2022] [Accepted: 05/23/2022] [Indexed: 12/16/2022]
Abstract
Despite increasing cesarean rates in Africa, there remain extensive gaps in the standard provision of care after cesarean birth. We present recommendations for discharge instructions to be provided to women following cesarean delivery in Rwanda, particularly rural Rwanda, and with consideration of adaptable guidelines for sub-Saharan Africa, to support recovery during the postpartum period. These guidelines were developed by a Technical Advisory Group comprised of clinical, program, policy, and research experts with extensive knowledge of cesarean care in Africa. The final instructions delineate between normal and abnormal recovery symptoms and advise when to seek care. The instructions align with global postpartum care guidelines, with additional emphasis on care practices more common in the region and address barriers that women delivering via cesarean may encounter in Africa. The recommended timeline of postpartum visits and visit activities reflect the World Health Organization protocols and provide additional activities to support women who give birth via cesarean. These guidelines aim to standardize communication with women at the time of discharge after cesarean birth in Africa, with the goal of improved confidence and clinical outcomes among these individuals.
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Affiliation(s)
| | - Bethany Hedt-Gauthier
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, USA.,Program in Global Surgery and Social Change, Harvard Medical School, Boston, Massachusetts, USA
| | - Amy Luo
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | | | - Grace Galvin
- Ariadne Labs, Brigham and Women's Hospital, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | | | - Rose L Molina
- Ariadne Labs, Brigham and Women's Hospital, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.,Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | - Adeline A Boatin
- Program in Global Surgery and Social Change, Harvard Medical School, Boston, Massachusetts, USA.,Department of Obstetrics and Gynecology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | | | | | - Joseph Ngonzi
- Department of Obstetrics and Gynecology, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Robert Riviello
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, USA.,Program in Global Surgery and Social Change, Harvard Medical School, Boston, Massachusetts, USA.,Center for Surgery and Public Health, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Katherine Semrau
- Ariadne Labs, Brigham and Women's Hospital, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.,Department of Medicine, Harvard Medical School, Boston, Massachusetts, USA.,Division of Global Health Equity, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Félix Sayinzoga
- Maternal, Child and Community Health Division, Rwanda Biomedical Center, Kigali, Rwanda
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11
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Health-related quality of life among postpartum women with preeclampsia, southern Ethiopia: a prospective cohort study. Health Qual Life Outcomes 2022; 20:147. [PMID: 36309707 PMCID: PMC9618225 DOI: 10.1186/s12955-022-02061-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 10/14/2022] [Indexed: 11/21/2022] Open
Abstract
Background Preeclampsia affects the health of the mother and the fetus during pregnancy and childbirth. To date, little is known about the impact of preeclampsia on postpartum health-related to quality of life (HRQoL) in the Sidama region of southern Ethiopia. This study aimed to measure the HRQoL and its contributing factors among postpartum women with preeclampsia in the Sidama region. Methods A prospective cohort study was conducted by enrolling pregnant women at ≥20 weeks of gestation up until the 37th week of gestation. We then followed them until 12 weeks after delivery. A locally validated, World Health Organization Quality-of-Life-BREF (WHOQOL-BREF) tool was used to assess participants’ HRQoL at two time points; the 6th and 12th weeks postpartum. Assessment of HRQoL of participants was based on total scores on the WHOQoL-BREF. Higher scores on the WHOQoL-BREF reflected a higher HRQoL. Multiple linear regression analyses were performed to evaluate the contributing factors to HRQoL. The level of significance was determined at a p-value of < 0.05. Results The HRQoL of postpartum women with preeclampsia significantly improved over time from 6 (151 ± 17) to 12 weeks (167 ± 18), p < 0.001). However, the overall HRQoL scores were lower (156 ± 16, p < 0.001) among women with preeclampsia compared to normotensive women (181 ± 21). An experience of early neonatal death was found to have a significant negative effect on the HRQoL of women with preeclampsia [β = − 2.1, 95% CI: − 3.43– − 0.85] compared to normotensive women who did not have early neonatal death. At 6 weeks of the postpartum period, the physical domain was found to have a significantly higher contribution to the lower HRQoL [β = 1.04, 95% CI: 0.88–1.12] compared to normotensive women, while other factors were constant. Conclusions The HRQoL of women with preeclampsia improved over time from 6 to 12 weeks in the postpartum period. Lower HRQoL was observed among postpartum women with preeclampsia, especially among those who experienced preterm birth or early neonatal death. The effects of preeclampsia on the HRQoL of postpartum women should be considered in redesigning postnatal care intervention services. Supplementary Information The online version contains supplementary material available at 10.1186/s12955-022-02061-2.
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12
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Thipanyane MP, Nomatshila SC, Musarurwa HT, Oladimeji O. The Roles and Challenges of Traditional Health Practitioners in Maternal Health Services in Rural Communities of Mthatha, South Africa. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13597. [PMID: 36294175 PMCID: PMC9603220 DOI: 10.3390/ijerph192013597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 10/14/2022] [Accepted: 10/19/2022] [Indexed: 06/16/2023]
Abstract
Traditional health practitioners (THPs) are considered as the entry level of care in African societies and play an important role in the delivery of health services to the population. A phenomenological qualitative study was carried out among purposefully selected THPs in Mthatha to understand their roles and the challenges they face in providing maternal health services. The study included a focus group discussion with seven participants which yielded three themes and seven subthemes. The content analysis of descriptive data from the focus group discussion revealed threats posed by unregistered and counterfeit THPs to the lives of pregnant women in rural settings. The THPs' wide range of services allowed pregnant women to receive prenatal, antenatal, and postnatal care in proximity. However, this community level of care was marked by high levels of secrecy and counterfeit practitioners who used human body parts, which compromised the practice and rendered it unpopular. The South African government recommended the establishment of a register for THPs in order to protect the public, including the clarification of functional referral pathways between THPs and conventional health services.
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Affiliation(s)
- Mvulakazi Patricia Thipanyane
- Department of Public Health, Preventive Medicine and Health Behavior Unit, Faculty of Health Sciences, Walter Sisulu University, Mthatha 5117, South Africa
| | - Sibusiso Cyprian Nomatshila
- Department of Public Health, Preventive Medicine and Health Behavior Unit, Faculty of Health Sciences, Walter Sisulu University, Mthatha 5117, South Africa
| | - Hannibal Tafadzwa Musarurwa
- Department of Human Biology, Faculty of Health Sciences, Walter Sisulu University, Mthatha 5117, South Africa
| | - Olanrewaju Oladimeji
- Department of Public Health, Community Medicine Unit, Faculty of Health Sciences, Walter Sisulu University, Mthatha 5117, South Africa
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13
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Mutombo CS, Bakari SA, Ntabaza VN, Nachtergael A, Lumbu JBS, Duez P, Kahumba JB. Perceptions and use of traditional African medicine in Lubumbashi, Haut-Katanga province (DR Congo): A cross-sectional study. PLoS One 2022; 17:e0276325. [PMID: 36256659 PMCID: PMC9578634 DOI: 10.1371/journal.pone.0276325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Accepted: 10/05/2022] [Indexed: 11/06/2022] Open
Abstract
In the Democratic Republic of Congo, the desire of the Ministry of Health to integrate Traditional African Medicine into the Official Health System remains limited by the lack of reliable data on several aspects of this medicine. This study aims to determine the perceptions of the Lubumbashi population towards Traditional African Medicine and the contexts of recourse to these therapeutic modalities. We conducted semi-structured interviews of population samples in each of the 7 Lubumbashi municipalities, which were semi-randomly selected in proportions to each population size, from January to June 2017 and from February to July 2018. A total of 4278 people (average age, 32.1 ± 10.4 years; 36.5% of women) have been surveyed. Among them, 75.8% define "Traditional African Medicine" as "herbal-based treatments"; 79.4% have resorted to traditional medicine, for several pathologies and social problems. This medicine was preferred for efficiency, speed of healing and low cost, as well as the presence of the diseases against which it would be the only one used. Most, (52.1%) have started with Conventional Medicine, then resorted to Traditional African Medicine, 34.7% started directly with Traditional African Medicine, while 13.2% combined these two medicines. From those who have resorted to Traditional African Medicine (n = 3396), 55% declare no concern towards traditional medicine, while 42.5% fear looseness, overdose, intoxication, and lack of hygiene; from those who have not resorted to Traditional African Medicine (n = 882), 78% are fearful of fear looseness, witchcraft, and fetishism. Traditional African Medicine remains an important health care resource for the Lubumbashi people. It is essential that decision-makers consider the importance of this health sector for the population, but also the reported fears and hindrances, and work towards the regulation, sanitization, and control of this medicine to ensure its safe use.
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Affiliation(s)
- Cedrick S Mutombo
- Laboratory of Pharmacognosy, Department of Pharmacology, Faculty of Pharmaceutical Sciences, Université de Lubumbashi, Lubumbashi, DR Congo
- Unit of Therapeutic Chemistry and Pharmacognosy, Faculty of Medicine and Pharmacy, University of Mons, Mons, Belgium
| | - Salvius A Bakari
- Laboratory of Pharmacognosy, Department of Pharmacology, Faculty of Pharmaceutical Sciences, Université de Lubumbashi, Lubumbashi, DR Congo
| | - Vianney N Ntabaza
- Laboratory of Pharmacognosy, Department of Pharmacology, Faculty of Pharmaceutical Sciences, Université de Lubumbashi, Lubumbashi, DR Congo
| | - Amandine Nachtergael
- Unit of Therapeutic Chemistry and Pharmacognosy, Faculty of Medicine and Pharmacy, University of Mons, Mons, Belgium
| | - Jean-Baptiste S Lumbu
- Service de Chimie Organique, Département de Chimie, Faculté des Sciences, Université de Lubumbashi, Lubumbashi, DR Congo
| | - Pierre Duez
- Unit of Therapeutic Chemistry and Pharmacognosy, Faculty of Medicine and Pharmacy, University of Mons, Mons, Belgium
| | - Joh B Kahumba
- Laboratory of Pharmacognosy, Department of Pharmacology, Faculty of Pharmaceutical Sciences, Université de Lubumbashi, Lubumbashi, DR Congo
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14
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Makola Z, Tabane R. South African employees’ perceptions of the inclusion of traditional health practitioners’ services in workplace employee assistance programmes. JOURNAL OF WORKPLACE BEHAVIORAL HEALTH 2022. [DOI: 10.1080/15555240.2022.2130347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Zamandlovu Makola
- Department of Human Resource Management, College of Economic and Management Sciences, University of South Africa, Pretoria, South Africa
| | - Ramodungoane Tabane
- Department of Psychology of Education, College of Education, University of South Africa, Pretoria, South Africa
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15
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Mohlabane N. Unsettling knowledge boundaries: the Indigenous pitiki space for Basotho women's sexual empowerment and reproductive well-being. HEALTH SOCIOLOGY REVIEW : THE JOURNAL OF THE HEALTH SECTION OF THE AUSTRALIAN SOCIOLOGICAL ASSOCIATION 2022; 31:158-172. [PMID: 35634929 DOI: 10.1080/14461242.2022.2079092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Accepted: 05/11/2022] [Indexed: 06/15/2023]
Abstract
Indigenous knowledge systems embody a holistic, inclusive view of the world and foreground interconnectedness for the promotion of life. Through reflective engagement with the author's positioning as an Indigenous researcher, this article explores Indigenous knowledges of sexual, reproductive health and motherhood shared by Basotho women. It draws on the life stories of twenty never-married women and uses decolonial African feminist approaches to challenge the assumed universality of conceptions of sexual and reproductive health that are both deeply embedded and produced within specific relations of power. It illuminates the Indigenous pitiki space as an Indigenous knowledge hub purposed to empower Basotho women's sexual and reproductive health. Within this space, Indigenous knowledges and skills are shared amongst women, with the elderly imparting knowledges to the young women. In the context of unsurmountable health disparities, the article shows how Indigenous knowledge-sharing outside the exclusive 'westernised' health systems enables communal support for the well-being of women and children in African contexts. It emphasises the need for inclusive and expansive knowledge production systems not only to better inform equitable health solutions for Indigenous communities but also for epistemic redress in the discipline of Sociology.
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Affiliation(s)
- Neo Mohlabane
- Sociology Department, University of Pretoria, Pretoria, South Africa
- Human Sciences Research Council, Developmental, Capable & Ethical State (DCES), Pretoria, South Africa
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16
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Mudonhi N, Nunu WN. Traditional Medicine Utilisation Among Pregnant Women in Sub-saharan African Countries: A Systematic Review of Literature. INQUIRY: THE JOURNAL OF HEALTH CARE ORGANIZATION, PROVISION, AND FINANCING 2022; 59:469580221088618. [PMID: 35506677 PMCID: PMC9073130 DOI: 10.1177/00469580221088618] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
Traditional medicine has the potential to boost the health and economies of many SSA countries, especially if regulatory mechanisms are deployed to govern their protection and utilisation. There is lack of knowledge regarding traditional medicines and their impact on pregnancy. This paper reviews the literature on traditional medicine utilisation among pregnant women in Sub-Saharan African countries. The paper, determined the proportion of pregnant women utilising traditional medicines in Sub-Saharan Africa, identified the different types of traditional medicine used during antenatal care and reasons for Use in Sub-Saharan Africa and also identified challenges that are faced by women who use traditional medicine in antenatal care. A systematic exploratory review was conducted guided by the PRISMA framework. The databases that were searched included Google Scholar, PubMed, Cochrane, HINARI and the World Health Organization. Forty-one literature sources were eligible and included in the review process. Reported traditional medicine utilisation ranged between 12 and 93% among pregnant women in Sub-Saharan Africa. Different types of traditional medicines have been utilised in Sub-Saharan Africa for different purposes. Safety and poor management of usage were reported to be some of the challenges associated with traditional medicine. There is a need to determine chemical components and mode of action of these herbs as some could be beneficial, whilst others harmful, leading to severe pregnancy complications.
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Affiliation(s)
- Nicholas Mudonhi
- Department of Environmental Science and Health, Faculty of Applied Sciences, National University of Science and Technology, Bulawayo, Zimbabwe
| | - Wilfred N. Nunu
- Department of Environmental Science and Health, Faculty of Applied Sciences, National University of Science and Technology, Bulawayo, Zimbabwe
- Scientific Agriculture and Environment Development Institute, National University of Science and Technology, Bulawayo, Zimbabwe
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Herb-drug interactions: Perception and revelations of nurses in primary healthcare clinics, South Africa. INTERNATIONAL JOURNAL OF AFRICA NURSING SCIENCES 2022. [DOI: 10.1016/j.ijans.2022.100409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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18
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Leke AZ, Dolk H, Loane M, Casson K, Maboh NM, Maeya SE, Dibo L, Nyenti PB, Obale A, Etiendem D. Prevalence, determinants and attitude towards herbal medicine use in the first trimester of pregnancy in Cameroon: A survey in 20 hospitals. PLOS GLOBAL PUBLIC HEALTH 2022; 2:e0000726. [PMID: 36962818 PMCID: PMC10021538 DOI: 10.1371/journal.pgph.0000726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 08/04/2022] [Indexed: 11/18/2022]
Abstract
To examine the prevalence, determinants and attitude towards herbal medication (HM) use in the first trimester of pregnancy in Cameroon women. Between March to August 2015, we surveyed 795 pregnant women attending 20 randomly selected urban or rural hospitals in South West Cameroon on first trimester orthodox medication (OM) and HM use. Data was obtained by interviews using structured questionnaires. First trimester HM use was reported by 293 (36∙9%) women, 76% of whom used it in combination with OM. The most frequent indication for taking HM was prevention/treatment of anaemia (26∙3%). The HM were usually self-prescribed (33∙3%) or by family (56∙2%), and obtained from the woman's own garden (69∙3%). Twenty percent of women believed that HM was always safe to take in pregnancy, compared to 69.3% for OM. Intake of HM was significantly influenced by women's opinion on OM or HM safety-the odds of taking HM was 3 time higher among women who were unsure about the safety of OM (AOR: 3∙0, 95%CI = 1∙5-6∙1), while women who thought HM were never safe or who were unsure about its safety, were 91% or 84% respectively less likely to take HM compared to women who believed HM were always safe. We identified a high prevalence of HM use and concomitant use with OM, strongly influenced by women's perception of HM and OM safety. These findings indicate the need for WHO to specifically address safety in pregnancy in its policy to integrate traditional medicine use into existing healthcare systems in Africa.
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Affiliation(s)
- Aminkeng Zawuo Leke
- Centre for Maternal, Fetal and Infant Research, Institute for Nursing and Health Research, Ulster University, Jordanstown, United Kingdom
- Centre for Maternal and Infant Research, Health Research Foundation (HRF), Buea, Cameroon
| | - Helen Dolk
- Centre for Maternal, Fetal and Infant Research, Institute for Nursing and Health Research, Ulster University, Jordanstown, United Kingdom
| | - Maria Loane
- Centre for Maternal, Fetal and Infant Research, Institute for Nursing and Health Research, Ulster University, Jordanstown, United Kingdom
| | - Karen Casson
- Centre for Maternal, Fetal and Infant Research, Institute for Nursing and Health Research, Ulster University, Jordanstown, United Kingdom
| | - Nkwati Michel Maboh
- Centre for Maternal and Infant Research, Health Research Foundation (HRF), Buea, Cameroon
| | - Susan Etta Maeya
- Centre for Maternal and Infant Research, Health Research Foundation (HRF), Buea, Cameroon
| | - Lerry Dibo
- Centre for Maternal and Infant Research, Health Research Foundation (HRF), Buea, Cameroon
| | - Pauline Bessem Nyenti
- Centre for Maternal and Infant Research, Health Research Foundation (HRF), Buea, Cameroon
| | - Armstrong Obale
- Centre for Maternal and Infant Research, Health Research Foundation (HRF), Buea, Cameroon
| | - Derick Etiendem
- Centre for Maternal and Infant Research, Health Research Foundation (HRF), Buea, Cameroon
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Shewamene Z, Dune T, Smith CA. Acculturation and use of traditional medicine among African migrant women in Sydney: a mixed method study. BMC Complement Med Ther 2021; 21:249. [PMID: 34615504 PMCID: PMC8495915 DOI: 10.1186/s12906-021-03424-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Accepted: 09/17/2021] [Indexed: 11/17/2022] Open
Abstract
Background More than 80% of the African population depend on traditional medicine as a primary healthcare. Although the African migrant community is increasing in Australia, there is no research documenting if and how African migrant communities have maintained or changed their use of traditional health practices after migration. This study aims to answer the following research questions: does acculturation influence the use of traditional medicine? and how are cultural health practices or beliefs manifested among African migrant women in Australia? Method A mixed methods design which involved a cross-sectional survey (n = 319) and individual interviews (n = 15) was conducted. Survey data were analysed using SPSS (version 23) and logistic regression model was used to test associations. Qualitative data were analysed thematically using NVivo 11 software to identify themes and conceptual categories in the participants’ responses. The study was informed by acculturation theory. Result Both the survey and the interview data indicated that cultural health practices were retained as an important form of healthcare for African migrant women in Sydney. The findings indicated that African migrants continued to use traditional medicines as part of their cultural identity and to build cohesive ethnic community to share traditional values and cultural practices. Women who relatively stayed for shorter period of time in Australia and migrated at a later age were more likely to use TM. Conclusion Acculturation proxy measures increased the likelihood of TM use suggesting African migrant women retain their cultural health practices in Australia and use of TM was manifested as part of their cultural identity. The findings have implications to improve the provision of culturally sensitive and responsive health services when caring for African migrant women.
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Affiliation(s)
- Zewdneh Shewamene
- Ethiopian Health Insurance Agency (EHIA), P.O.Box 1176, Addis Ababa, Ethiopia. .,NICM Health Research Institute, Western Sydney University, Penrith, NSW, 2751, Australia.
| | - Tinashe Dune
- School of Health Sciences, Translational Health Research Institute & Diabetes Obesity and Metabolism Translational Research Unit, Western Sydney University, Penrith, NSW, 2751, Australia
| | - Caroline A Smith
- NICM Health Research Institute, Western Sydney University, Penrith, NSW, 2751, Australia.,Graduate Research School, Western Sydney University, Penrith, NSW, 2751, Australia
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20
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Ahmed SM, Sundby J, Aragaw YA, Nordeng H. Medicinal plants used among pregnant women in a tertiary teaching hospital in Jimma, Ethiopia: a cross-sectional study. BMJ Open 2021; 11:e046495. [PMID: 34429308 PMCID: PMC8386214 DOI: 10.1136/bmjopen-2020-046495] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVE The aim of this study was to investigate and describe the use of medicinal plants during pregnancy among women admitted in the Maternity and Gynaecology wards at Jimma University Medical Centre (JUMC) in the southwest Ethiopia. DESIGN Cross-sectional study. SETTING Maternity and Gynaecology wards at JUMC. PARTICIPANTS 1117 hospitalised pregnant women or postpartum women. MAIN OUTCOME MEASURES Our primary outcomes of interest were the prevalence of use, types of medicinal plants used and their utilisation among pregnant women. METHODS Data were collected through structured face-to-face interviews of pregnant women or postpartum women and review of patient medical records between February and June 2017. RESULTS Overall, 28.6% of the women reported use of at least one medicinal plant during the pregnancy. Twenty-seven different types of medicinal plants were used. The most commonly used medicinal plants were Linum usitatissimum L. (flaxseed-use with caution) 22.0%, Ocimum lamiifolium L. (damakessie-safety unknown) 3.6% and Carica papaya L. (papaya-use with caution) 3.1%. The most common reason for use was preparation, induction or shortening of labour. Lack of access to health facility (mainly health posts), admission to maternity ward, khat chewing and alcohol consumption were the strongest predictors of medicinal plants use during pregnancy (OR >2). Only five medicinal plants used by women had sufficient evidence to be classified as safe to use in pregnancy. CONCLUSIONS Almost one-third of women at the tertiary hospital in Ethiopia reported use of medicinal plants during pregnancy, most frequently to prepare, induce, reduce the intensity or shorten duration of labour. Increased awareness about potential benefits or risks of medicinal plants use during pregnancy among healthcare professionals and patients, and increased access to childbirth providing healthcare facilities are important in order to promote safer pregnancies and better health outcomes for women and their unborn children.
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Affiliation(s)
- Seid Mussa Ahmed
- Department of Community Medicine and Global Health, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
- Division of Social and Administrative Pharmacy, School of Pharmacy, Faculty of Health Sciences, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Johanne Sundby
- Department of Community Medicine and Global Health, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Yesuf Ahmed Aragaw
- Department of Obstetrics and Gynaecology, Faculty of Medical Sciences, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Hedvig Nordeng
- Pharmacoepidemiology and Drug Safety Research Group, Department of Pharmacy, Faculty of Mathematics and Natural Sciences, University of Oslo, Oslo, Norway
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Complementary and Alternative Medicine Use in a Pregnant Population, Northwest Ethiopia. Int J Reprod Med 2021; 2021:8829313. [PMID: 34414232 PMCID: PMC8369188 DOI: 10.1155/2021/8829313] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 07/06/2021] [Accepted: 07/29/2021] [Indexed: 11/17/2022] Open
Abstract
Background Complementary and alternative medicine (CAM) appears to be the source of healthcare particularly in the majority of pregnant communities of Africa due to its intrinsic qualities as well as its accessibility and affordability. Despite acknowledged benefits of CAM use in pregnancy, majority of users are unaware of its safety and effects on fetal development. The present study was aimed at examining CAM use among pregnant women in Northwest Ethiopia to provide an opportunity for future investigations on the effectiveness of CAM modalities in the management of pregnancy-related complications across the country. Methods This was an institution-based cross-sectional study which was conducted at Poly Clinic Health Center in the Northwest part of Ethiopia between March and May 2018. Two hundred and eighty two Ethiopian women were conveniently recruited to take part in the study. Structured questioners were used for the survey. Descriptive statistics of sociodemographic and CAM use characteristics were expressed in frequencies and proportions. Chi-square test was performed to determine the difference between CAM user and nonuser. Besides, binary logistic regression analyses were performed to examine predictors of CAM use in the study population. The result was considered statistically significant if P value ≤ 0.05. Results The prevalence rate of CAM use in pregnant women was 89.36% with the commonest practice of spiritual healing (65.2%) and herbal supplement (51.8%) CAM therapies. Use of CAM positively associated with marital status and previous number of children. The odds of using CAM among single/not married women were 3.22 times higher (COR: 3.22, CI: 1.07-9.64) as compared to married women. Pregnant women with no children were 3.30 times more likely (COR: 3.30, CI: 0.92-11.84) to use CAM than those women having ≥3 children. Lower odds of using CAM significantly associated with educational level (COR: 0.20, CI: 0.046-0.93) and antenatal care (COR: 0.45, CI: 0.18-1.13) in a binary logistic regression model. Conclusions A considerable number of pregnant women were utilizing CAM including herbal products as part of their maternity care. This finding provides a reference on the use of CAM for policy-makers, health professionals, and parents. Further studies are needed to investigate the effectiveness and safety of specific CAM modalities with particular focus on herbal medicinal products.
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Ethno-medicinal, phytochemistry, and pharmacological importance of Hunteria umbellate (K. Schum.) Hallier f. (Apocynaceae): a useful medicinal plant of sub-Saharan Africa. CLINICAL PHYTOSCIENCE 2021. [DOI: 10.1186/s40816-021-00287-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Hunteria umbellate (K. Schum.) Hallier f. (Apocynaceae) is a tropical rainforest tree commonly found in sub-Saharan region of Africa. It is a useful and very popular plant among the locals due to the outstanding anti-diabetic activity of the seeds.
Methods
A comprehensive literature search on articles published on phytochemical analysis and various pharmacological activities of Hunteria umbellate was carried out using search engines such as Google Scholar, PubMed and Science Direct.
Results
In this review, it was deduced that H. umbellate is employed in folk medicine as an elixir for obesity, fever, leprosy sores, menstrual pain, infertility, yaws, intestinal worms, abdominal discomfort and stomach ache. Due to their durability and immunity against termites, the stems are coveted and desired as timbers in the construction of houses, while the bark has been reportedly exported to Europe for medicinal uses. Pharmacological activities such as fertility enhancing, aphrodisiac, hypoglycemic, anti-inflammatory, has been ascribed to the different morphological organs of H. umbellate. Moreover, compounds belonging to important classes of secondary metabolites with biological activities such as triterpenoids, flavonoids, tannins, alkaloids, quinic acids have been identified and characterized from the plant.
Conclusion
From this review, it can be inferred that, numerous and bioactive principles with known biological usefulness are present in the extracts of H. umbellate and might be responsible for the observed biological and pharmacological activities.
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Okaiyeto K, Oguntibeju OO. African Herbal Medicines: Adverse Effects and Cytotoxic Potentials with Different Therapeutic Applications. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:5988. [PMID: 34199632 PMCID: PMC8199769 DOI: 10.3390/ijerph18115988] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 05/19/2021] [Accepted: 05/25/2021] [Indexed: 01/01/2023]
Abstract
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.
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Affiliation(s)
| | - Oluwafemi O. Oguntibeju
- Phytomedicine and Phytochemistry Group, Oxidative Stress Research Centre, Department of Biomedical Sciences, Faculty of Health and Wellness Sciences, Cape Peninsula University of Technology, Bellville 7535, South Africa;
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Tengia-Kessy A, Msalale GC. Understanding forgotten exposures towards achieving Sustainable Development Goal 3: a cross-sectional study on herbal medicine use during pregnancy or delivery in Tanzania. BMC Pregnancy Childbirth 2021; 21:270. [PMID: 33794794 PMCID: PMC8017693 DOI: 10.1186/s12884-021-03741-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Accepted: 03/22/2021] [Indexed: 02/07/2023] Open
Abstract
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.
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Affiliation(s)
- Anna Tengia-Kessy
- Department of Community Health, School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, P. O. Box 65015, Dar es Salaam, Tanzania.
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Busse CE, Wilson ML, Bakari A, Moyer CA. Self-reported medicinal plant use by Ghanaian women during pregnancy is associated with poor neonatal health. J Public Health (Oxf) 2021; 44:319-328. [PMID: 33782702 DOI: 10.1093/pubmed/fdab033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 01/24/2021] [Accepted: 02/02/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND More than a third of pregnant women in Africa use medicinal plants (hereafter, 'herbs') during pregnancy, yet little is known about herb use among urban African women, or about the potential impact on newborns. METHODS This cross-sectional study of 504 women giving birth at an urban government hospital in Kumasi, Ghana (May-July 2018) collected data via chart reviews and maternal interviews. Data were analyzed using conditional logistic regression. RESULTS Of 380 singleton births with complete data, 102 mothers (26.84%) reported using herbs during pregnancy and/or delivery. Herb users and non-users did not differ significantly across a range of sociodemographic variables. Controlling for age, education, neonatal birthweight and household running water (socioeconomic status (SES) indicator), herb-using women were twice as likely to have their newborn admitted to the hospital (odds ratio (OR) = 2.05; confidence interval (CI) 95% 1.17, 3.60) and four times as likely to bear a child with a low Apgar score (OR = 4.09; CI 95% 1.66, 10.07) compared with non-users. CONCLUSION Urban-dwelling Ghanaian women from diverse backgrounds use herbs during pregnancy. Maternal herb use was associated with poor neonatal outcomes, regardless of the baby's birthweight and mother's age, education or SES, suggesting the importance of educating all women about the possible negative impacts of herb use during pregnancy and delivery.
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Affiliation(s)
- Clara E Busse
- Department of Epidemiology, School of Public Health, The University of Michigan, Ann Arbor 48109, MI, USA
| | - Mark L Wilson
- Department of Epidemiology, School of Public Health, The University of Michigan, Ann Arbor 48109, MI, USA
| | - Ashura Bakari
- Department of Child Health, Suntreso Government Hospital, Ghana Health Service, Kumasi, Ghana
| | - Cheryl A Moyer
- Department of Learning Health Sciences, Medical School, The University of Michigan, Ann Arbor 48109, MI, USA
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Kajungu D, Muhoozi M, Stark J, Weibel D, Sturkenboom MCJM. Vaccines safety and maternal knowledge for enhanced maternal immunization acceptability in rural Uganda: A qualitative study approach. PLoS One 2020; 15:e0243834. [PMID: 33301495 PMCID: PMC7728220 DOI: 10.1371/journal.pone.0243834] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Accepted: 11/26/2020] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Maternal immunization is a successful and cost-effective public health strategy. It protects pregnant women and their infants from vaccine-preventable diseases. Uganda is exploring new vaccines for pregnant women like replacing Tetanus Toxoid (TT) with Tetanus-Diphtheria (Td). Research on knowledge, attitudes, beliefs, and willingness among pregnant women is needed before the introduction of vaccines for pregnant women. This study was aimed at exploring maternal knowledge, attitudes, willingness, and beliefs towards maternal immunization among pregnant women in rural Uganda. METHODS This was a qualitative descriptive study. Ten focus group discussions (FGDs) were conducted at antenatal care (ANC) clinics and in a rural community of Uganda. Five key informant interviews (KIIs) were done with health workers, for triangulation. Considering context and research characteristics, data were collected and thematically analyzed. RESULTS Women were familiar with the importance of maternal vaccines, had positive attitudes, and expressed willingness to take them. Acceptance of a new vaccine could be affected by worries of pregnant women and that of their partners, who influence health seeking decisions in a home concerning adverse events, following the maternal immunization (AEFI). There were misconceptions about introduction of vaccines such as the belief that vaccines treat malaria and general body weakness, and being used as guinea pigs to test for the vaccine before its introduction to the larger population. CONCLUSION A range of diverse sentiments and beliefs may affect uptake and acceptability of vaccines that are introduced in communities. For instance, ignoring vaccine safety concerns may impede maternal immunization acceptability, because pregnant women and their husbands are concerned about AEFI. Moreover, husbands make all health-seeking decisions at home, and their opinion is key, when considering such interventions.
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Affiliation(s)
- Dan Kajungu
- Makerere University Center for Health and Population Research (MUCHAP), Kampala, Uganda
- Julius Global Health, University Utrecht Medical Center, Utrecht, The Netherlands
- * E-mail:
| | - Michael Muhoozi
- Makerere University Center for Health and Population Research (MUCHAP), Kampala, Uganda
| | - James Stark
- Putnam Associates, Boston, Massachusetts, United States of America
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Adama EA, Sundin D, Bayes S. Sociocultural Practices Affecting the Care of Preterm Infants in the Ghanaian Community. J Transcult Nurs 2020; 32:458-465. [PMID: 33225863 PMCID: PMC8404725 DOI: 10.1177/1043659620975098] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Introduction Although culture is an integral part of health, there is scarcity of evidence on the influence of culture on caregiving experiences of parents of preterm infants. The aim of this study was to explore the influence of sociocultural practices on caring for preterm infants in the Ghanaian community. Method Narrative inquiry was utilized to explore the influence of sociocultural practices on the care of preterm infants from 21 mothers, 9 fathers, and 12 household members. Data were collected through face-to-face semistructured interviews and observations at participants’ homes. Results Analysis of data resulted in three threads/themes—respect for the elderly, use of herbal medicines, and communal living. Discussion Community and extended family members have great influence on the care of preterm infants. Traditional herbal medicines are considered effective in treating traditional illnesses among preterm infants. Understanding the influence of culture on the care of vulnerable preterm infants in the community is essential in developing interventions for infant survival.
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Affiliation(s)
| | - Deborah Sundin
- Edith Cowan University, Joondalup, Western Australia, Australia
| | - Sara Bayes
- Edith Cowan University, Joondalup, Western Australia, Australia
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Govender D, Taylor M, Naidoo S. Adolescent Pregnancy and Parenting: Perceptions of Healthcare Providers. J Multidiscip Healthc 2020; 13:1607-1628. [PMID: 33239882 PMCID: PMC7680673 DOI: 10.2147/jmdh.s258576] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Accepted: 09/17/2020] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Adverse maternal and child health outcomes due to adolescent pregnancy are central to public health research and practice. In addition, public health has emphasised that the care rendered by healthcare providers plays a pivotal role in the health and well-being of pregnant and parenting adolescents. Healthcare providers may differ in the ways they interpret adolescent pregnancy and parenting and consequently, this may have profound implications for healthcare decision making. The aim of this study was to explore the multiple perspectives of a diverse group of healthcare providers' delivering services and engaging with pregnant adolescents and adolescent mothers at a district hospital in Ugu, KwaZulu Natal, South Africa. METHODS This descriptive qualitative study used semi-structured interviews (n=33). Healthcare providers rendering care to pregnant and parenting adolescents were recruited from the maternity, antenatal, paediatrics, psychology, dietetics, physiotherapy and social work departments, as well as from the HIV/AIDS, STIs and TB (HAST) programme. The data were analysed using thematic analysis. RESULTS The healthcare providers acknowledged that adolescent pregnancy is a problematic issue in Ugu district. Furthermore, they felt that the postpartum sexual-related and reproductive health of adolescent mothers was not given priority. In the healthcare providers' view, the problems experienced by pregnant and parenting adolescents were school dropout, financial constraints, breakdown of relationships, abandonment, stigmatisation, parenting and child rearing difficulties, and both physical and mental health problems. CONCLUSION This study highlights that the issue of sexual- and reproductive-related outcomes of adolescent pregnancy and parenting is not given priority. In addition, the findings also highlighted the need for a multidisciplinary approach to the care of pregnant and parenting adolescents. Multidisciplinary communities of practices as interventions can be used to generate and share knowledge, capacitate healthcare providers and improve clinical practice. The training of healthcare providers, provision of non-judgemental counselling and tailored services for pregnant adolescents and adolescent mothers are essential. When appropriately disseminated, the findings will assist relevant healthcare providers, administrators in healthcare institutions, policymakers, and officials of the Department of Health and the Department of Education in South Africa to address the lack of appropriate care for pregnant and parenting adolescents.
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Affiliation(s)
- Desiree Govender
- KwaZulu-Natal Department of Health, South Africa Developing Research Innovation Localisation and Leadership (DRILL) Programme, University of KwaZulu-Natal, Durban, South Africa
- School of Nursing and Public Health, Discipline of Public Health Medicine, University of KwaZulu-Natal, Durban, South Africa
| | - Myra Taylor
- School of Nursing and Public Health, Discipline of Public Health Medicine, University of KwaZulu-Natal, Durban, South Africa
| | - Saloshni Naidoo
- School of Nursing and Public Health, Discipline of Public Health Medicine, University of KwaZulu-Natal, Durban, South Africa
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Traditional African remedies induce hemolysis in a glucose-6-phopshate dehydrogenase deficient zebrafish model. Sci Rep 2020; 10:19172. [PMID: 33154437 PMCID: PMC7645625 DOI: 10.1038/s41598-020-75823-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Accepted: 10/06/2020] [Indexed: 11/24/2022] Open
Abstract
Traditional remedies are widely used throughout Africa in routine care for infants. However, such remedies could have detrimental effects. Acute bilirubin encephalopathy (ABE) and kernicterus spectrum disorder (KSD) are common newborn health conditions in the developing world, contributing to substantial neonatal mortality and morbidity. They frequently occur in children with glucose-6-phopshate dehydrogenase (G6PD) deficiency. Using our established zebrafish model of G6PD deficiency, we tested the effects of three traditional compounds used in the care of the newborn umbilical cord: eucalyptus oil, methylated spirits, and Yoruba herbal tea. We found that eucalyptus oil induced a 13.4% increase in a hemolytic phenotype versus control, while methylated spirits showed a 39.7% increase in affected phenotype. Yoruba herbal tea exposure showed no effect. While methylated spirits are already a known pro-oxidant, these data indicate that eucalyptus oil may also be a hemolytic trigger in those with G6PD deficiency. Discovering which agents may contribute to the pathophysiology of G6PD deficiency is critical to eliminate ABE and KSD, especially in countries with a high prevalence of G6PD deficiency. The next step in elucidating the role of these agents is to determine the clinical correlation between the use of these agents and ABE/KSD.
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Govender D, Naidoo S, Taylor M. "I have to provide for another life emotionally, physically and financially": understanding pregnancy, motherhood and the future aspirations of adolescent mothers in KwaZulu-Natal South, Africa. BMC Pregnancy Childbirth 2020; 20:620. [PMID: 33054778 PMCID: PMC7557067 DOI: 10.1186/s12884-020-03319-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 10/07/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Adolescent pregnancy and motherhood has been a controversial and much disputed subject within the field of public health. Early childbearing is not only characterized as a physical body experience but also embodies the experiences and perceptions of the social norms, discourses, conflict and moral judgement. There is an increasing concern that the psychosocial challenges facing adolescent mothers remains in the background since research in this field has mainly focused on the medical and physical complications of early childbearing. The aim of this qualitative study was to explore adolescent pregnancy and motherhood in order to understand this phenomenon from the perspective of adolescent mothers and to gain insight into their future aspirations. METHODS This descriptive qualitative study was based on data from four focus group discussions with adolescent mothers utilising healthcare services at a district hospital in Ugu district, KwaZulu Natal, South Africa. The data were audio-recorded and transcribed verbatim, then analysed using thematic analysis. RESULTS Some adolescent mothers' partners were in denial and rejected them and the child while others' partners were happy and supported them during their pregnancy. Families' reactions to the pregnancies ranged between anger and disappointment to abandonment, the silent treatment, and acceptance and forgiveness. The psychological issues experienced by some of the adolescent mothers included suicidal ideation, guilt, loneliness, anxiety, and stress. They also experienced financial constraints, difficulty in returning to school, and stigmatisation in society. The participants envisioned completing their education, focusing on their dream careers, and contributing positively to society. CONCLUSION Experiences of adolescent pregnancy and parenting are multifaceted and the healthcare needs of pregnant and parenting adolescents extend beyond information and knowledge. A multidisciplinary approach is required in the care of adolescent mothers. A key policy priority should encompass the collaboration of different professionals from various healthcare sectors to assist adolescent mothers in achieving better health and psychosocial and socio-economic outcomes as steps to securing a better future for them.
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Affiliation(s)
- Desiree Govender
- KwaZulu-Natal Department of Health, Durban, South Africa
- School of Nursing and Public Health, Discipline of Public Health Medicine, University of KwaZulu-Natal, Durban, South Africa
- Developing Research Innovation Localisation and Leadership (DRILL) Fellow, Durban, South Africa
| | - Saloshni Naidoo
- School of Nursing and Public Health, Discipline of Public Health Medicine, University of KwaZulu-Natal, Durban, South Africa
| | - Myra Taylor
- School of Nursing and Public Health, Discipline of Public Health Medicine, University of KwaZulu-Natal, Durban, South Africa
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Dabe NE, Kefale AT, Dadi TL. Evaluation of Abortifacient Effect of Rumex nepalensis Spreng Among Pregnant Swiss Albino Rats: Laboratory-Based Study. J Exp Pharmacol 2020; 12:255-265. [PMID: 32801949 PMCID: PMC7402860 DOI: 10.2147/jep.s260719] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 06/19/2020] [Indexed: 11/23/2022] Open
Abstract
Background Rumex nepalensis Spreng (Amharic: Yewsha Tult) belongs to the Polygonaceae (buckwheat) family. In Ethiopia, the plant is traditionally used for the treatment of stomach ache, tonsillitis, ascariasis, uterine bleeding, etc. An ethnobotanical study from Mizan–Tepi University also reported the use of the plant by “Shekicho” people as an abortifacient. As a result, this study aimed at the assessment of the outcome of hydro-ethanolic leaves extract of R. nepalensis on Swiss albino pregnant rats and confirm its abortifacient activity. Methods The hydro-alcoholic leaves extract of Rumex nepalensis Spreng was evaluated for its abortifacient activity in Swiss albino rats. The mature female rats were mated overnight to male rats in mating cages. Two different dosage regimens (300 mg/kg, 600 mg/kg) of the extract were administered. Laparotomy was performed on the rats to assess the uterus and ovary, the viable, non-viable, adsorbing sites, and corpora lutea. Differences between the experimental and control groups were compared using one-way analysis of variance (ANOVA), followed by Dunnett’s T-test to determine their level of significance. Results and Discussion This study revealed that Rumex nepalensis Spreng had anti-implantation and abortifacient activities at both 300 and 600 mg/kg doses, which was statistically significant as compared with the controls. It was relatively safe up to the dose of 5000 mg/kg, where no mortality and organ toxicity were manifested. Phytochemicals identified were alkaloids, flavonoids, saponins, tannins, steroids, and anthraquinones. Conclusion In general, our study showed that R. nepalensis had a significant abortifacient activity that testifies its traditional dibs. Therefore, the use of this plant should be avoided in pregnant women to minimize unintended abortion and further studies are needed to know its mechanism of activity and to identify the phytochemicals corresponding to this activity. Checking its efficacy on other species is also needed. ![]()
Point your SmartPhone at the code above. If you have a QR code reader the video abstract will appear. Or use: https://youtu.be/Nub-t1izypU
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Affiliation(s)
- Nikodimos Eshetu Dabe
- Department of Biomedical Science, College of Health Sciences, Mizan-Tepi University, Mizan Teferi, Ethiopia
| | - Adane Teshome Kefale
- Department of Pharmacy, College of Health Sciences, Debre Berhan University, Debre Berhan, Ethiopia
| | - Tegene Legese Dadi
- Department of Public Health, College of Health Sciences, Mizan-Tepi University, Mizan Teferi, Ethiopia
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Picetti R, Miller L, Shakur-Still H, Pepple T, Beaumont D, Balogun E, Asonganyi E, Chaudhri R, El-Sheikh M, Vwalika B, Arulkumaran S, Roberts I. The WOMAN trial: clinical and contextual factors surrounding the deaths of 483 women following post-partum haemorrhage in developing countries. BMC Pregnancy Childbirth 2020; 20:409. [PMID: 32677911 PMCID: PMC7364536 DOI: 10.1186/s12884-020-03091-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Accepted: 07/03/2020] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Post-partum haemorrhage (PPH) is a leading cause of maternal death worldwide. The WOMAN trial assessed the effects of tranexamic acid (TXA) on death and surgical morbidity in women with PPH. The trial recorded 483 maternal deaths. We report the circumstances of the women who died. METHODS The WOMAN trial recruited 20,060 women with a clinical diagnosis of PPH after a vaginal birth or caesarean section. We randomly allocated women to receive TXA or placebo. When a woman died, we asked participating clinicians to report the cause of death and to provide a short narrative of the events surrounding the death. We collated and edited for clarity the narrative data. RESULTS Case fatality rates were 3.0% in Africa and 1.7% in Asia. Nearly three quarters of deaths were within 3 h of delivery and 91% of these deaths were from bleeding. Women who delivered outside a participating hospital (12%) were three times more likely to die (OR = 3.12, 95%CI 2.55-3.81) than those who delivered in hospital. Blood was often unavailable due to shortages or because relatives could not afford to buy it. Clinicians highlighted late presentation, maternal anaemia and poor infrastructure as key contributory factors. CONCLUSIONS Although TXA use reduces bleeding deaths by almost one third, mortality rates similar to those in high income countries will not be achieved without tackling late presentation, maternal anaemia, availability of blood for transfusion and poor infrastructure.
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Affiliation(s)
- Roberto Picetti
- Clinical Trials Unit, London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.
| | - Lori Miller
- Clinical Trials Unit, London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
| | - Haleema Shakur-Still
- Clinical Trials Unit, London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
| | - Tracey Pepple
- Clinical Trials Unit, London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
| | - Danielle Beaumont
- Clinical Trials Unit, London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
| | - Eni Balogun
- Clinical Trials Unit, London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
| | - Etienne Asonganyi
- Maternity Unit, Kumba District Hospital, Kumba, Southwest Province, Cameroon
| | - Rizwana Chaudhri
- Holy Family Hospital, Gynaecology & Obstetrics Unit 1, F-762 Said Pur Road, Satellite Town, Rawalpindi, Pakistan
| | - Mohamed El-Sheikh
- Department of Obstetrics and Gynaecology, Faculty of Medicine, University of Khartoum, Khartoum, Sudan
| | - Bellington Vwalika
- Department of Obstetrics and Gynaecology, School of Medicine, University of Zambia, Lusaka, Zambia
| | - Sabaratnam Arulkumaran
- St George's University of London, Room 1.126, First Floor, Jenner Wing, Cranmer Terrace, London, SW17 0RE, UK
| | - Ian Roberts
- Clinical Trials Unit, London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
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Herbal medicine use among pregnant women attending antenatal clinics in Lusaka Province, Zambia: A cross-sectional, multicentre study. Complement Ther Clin Pract 2020; 40:101218. [PMID: 32891293 DOI: 10.1016/j.ctcp.2020.101218] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 06/19/2020] [Accepted: 06/25/2020] [Indexed: 11/21/2022]
Abstract
BACKGROUND AND PURPOSE: The study of herbal medicine (HM) use which is related to maternal health, a public health priority in many sub-Saharan African countries including Zambia, has been limited. Accordingly, we aimed to determine the prevalence and patterns of HM use during pregnancy in Lusaka Province, Zambia. MATERIALS AND METHODS A survey-based (interviewer-administered), cross-sectional, multicentre study was conducted in 446 adult pregnant women attending antenatal clinics in June/July 2019. RESULTS Overall, 57.8% of participants reported using HM during their current pregnancy, with a mean of 2.0 ± 1.5 remedies/woman. Logistic regression analysis showed that HM use was significantly associated with HM use in prior pregnancies (p < 0.001) and willingness to use HM in the future (p < 0.001). The most commonly used herbs were lemon for nausea/vomiting and common cold, soybean to boost energy, ginger for common cold and nausea/vomiting, and Aloe vera for skin care. The perceived safety of HM (37.6%) and its complementary action with conventional medicines (35.3%) were the main reasons for HM use. CONCLUSION HM use among pregnant women attending antenatal clinics in Lusaka Province, Zambia is common, and a wide range of herbs is used.
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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. [PMID: 32581815 PMCID: PMC7296102 DOI: 10.3389/fphar.2020.00866] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Accepted: 05/26/2020] [Indexed: 12/15/2022] Open
Abstract
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.
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Affiliation(s)
- Magalie El Hajj
- Centre for International Health, University of Bergen, Bergen, Norway.,Medical Affairs, Partner 4 Health, Paris, France
| | - Lone Holst
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.,Centre for Pharmacy, University of Bergen, Bergen, Norway
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Onakpoya I. Use of herbal products in pregnancy: harms are reported but the benefit to harm balance is uncertain. BMJ Evid Based Med 2020; 25:1-2. [PMID: 31446400 DOI: 10.1136/bmjebm-2019-111240] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/23/2019] [Indexed: 11/03/2022]
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Fukunaga R, Morof D, Blanton C, Ruiz A, Maro G, Serbanescu F. Factors associated with local herb use during pregnancy and labor among women in Kigoma region, Tanzania, 2014-2016. BMC Pregnancy Childbirth 2020; 20:122. [PMID: 32085731 PMCID: PMC7035699 DOI: 10.1186/s12884-020-2735-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Accepted: 01/09/2020] [Indexed: 11/11/2022] Open
Abstract
Background Despite research suggesting an association between certain herb use during pregnancy and delivery and postnatal complications, herbs are still commonly used among pregnant women in sub-Sahara Africa (SSA). This study examines the factors and characteristics of women using local herbs during pregnancy and/or labor, and the associations between local herb use and postnatal complications in Kigoma, Tanzania. Methods We analyzed data from the 2016 Kigoma Tanzania Reproductive Health Survey (RHS), a regionally representative, population-based survey of reproductive age women (15–49 years). We included information on each woman’s most recent pregnancy resulting in a live birth during January 2014–September 2016. We calculated weighted prevalence estimates and used multivariable logistic regression to calculate adjusted odds ratios (aOR) and 95% confidence intervals (CI) for factors associated with use of local herbs during pregnancy and/or labor, as well as factors associated with postnatal complications. Results Of 3530 women, 10.9% (CI: 9.0–13.1) used local herbs during their last pregnancy and/or labor resulting in live birth. The most common reasons for taking local herbs included stomach pain (42.9%) and for the health of the child (25.5%). Adjusted odds of local herb use was higher for women reporting a home versus facility-based delivery (aOR: 1.6, CI: 1.1–2.2), having one versus three or more prior live births (aOR: 1.8, CI: 1.4–2.4), and having a household income in the lowest versus the highest wealth tercile (aOR: 1.4, CI: 1.1–1.9). Adjusted odds of postnatal complications were higher among women who used local herbs versus those who did not (aOR: 1.5, CI: 1.2–1.9), had four or more antenatal care visits versus fewer (aOR: 1.4, CI: 1.2–1.2), and were aged 25–34 (aOR: 1.1, CI: 1.0–1.3) and 35–49 (aOR: 1.3, CI: 1.0–1.6) versus < 25 years. Conclusions About one in ten women in Kigoma used local herbs during their most recent pregnancy and/or labor and had a high risk of postnatal complications. Health providers may consider screening pregnant women for herb use during antenatal and delivery care as well as provide information about any known risks of complications from herb use.
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Affiliation(s)
- R Fukunaga
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA. .,Epidemic Intelligence Service, Atlanta, Georgia, USA.
| | - D Morof
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.,United States Public Health Service, Atlanta, USA
| | - C Blanton
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - A Ruiz
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - G Maro
- Bloomberg Philanthropies, New York, New York, United States
| | - F Serbanescu
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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Shewamene Z, Dune T, Smith CA. Use of traditional and complementary medicine for maternal health and wellbeing by African migrant women in Australia: a mixed method study. BMC Complement Med Ther 2020; 20:60. [PMID: 32070348 PMCID: PMC7076811 DOI: 10.1186/s12906-020-2852-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Accepted: 02/11/2020] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Traditional medicine serves as a form of primary health care for more than 80% of African populations. Currently, there is no research documenting if and how African migrant communities engage with their traditional health practices and beliefs after they resettle in Western countries. The aim of this study was to examine African migrant women's experiences and perspectives about traditional and complementary medicine use in relation to their maternal health and wellbeing in Australia. METHODS We conducted a mixed method study between December 2016 and October 2017. Questionnaires were completed by 319 women and 15 in-depth interviews were conducted among African migrant women residing across the Sydney metropolitan area, Australia. Survey data were analysed using SPSS (version 23) and logistic regression model was used to test associations. Qualitative data were analysed thematically using NVivo 11 software to identify themes and conceptual categories in the participants' responses. The study was informed by Andersen's Socio-behavioural model of health service utilisation. RESULTS The findings indicated that use of traditional and complementary medicine was high and continued to be well used following African women's resettlement in Australia. The survey found that 232 (72.7%) women use some form of traditional and complementary medicine for maternal health and wellbeing purposes. Most women (179, 77.2%) reported that maintaining their maternal health and wellbeing was the most common reason for use. The interview findings indicated that access to traditional medicine included making requests from relatives and friends who travelled to Africa looking for a similar medicinal plant in Australia and preparing home remedies with advice from family members and healers back in Africa. Age ≥ 35 years (OR, 16.5; 95%CI, 6.58-41.5; p < 0.001), lower education (OR, 24; 95%CI, 8.18-71.1; p < 0.001), parity (OR, 7.3; 95%CI, 1.22-42.81; p = 0.029), and lower income (OR, 2.7; 95%CI, 1.23-5.83; p = 0.013) were strong predictors of traditional medicine use. CONCLUSION Use of traditional and complementary medicine among African migrant women in Sydney remained high following resettlement in Australia. As noted in Andersen's sociobehavioural model of health service utilisation, specific predisposing and enabling factors including age, education and income were associated with use of traditional and complementary medicine.
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Affiliation(s)
- Zewdneh Shewamene
- NICM Health Research Institute, Western Sydney University, Penrith, NSW, 2751, Australia. .,Center for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), Addis Ababa University, PO Box 9086, Addis Ababa, Ethiopia.
| | - Tinashe Dune
- School of Health Sciences, Western Sydney University, Penrith, NSW, 2751, Australia.,Translational Health Research Institute, Western Sydney University, Penrith, NSW, 2751, Australia
| | - Caroline A Smith
- NICM Health Research Institute, Western Sydney University, Penrith, NSW, 2751, Australia.,Translational Health Research Institute, Western Sydney University, Penrith, NSW, 2751, Australia.,Graduate Research School, Western Sydney University, Penrith, NSW, 2751, Australia
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Gesesew H, Lyon P, Ward P, Woldemichael K, Mwanri L. "Our Tradition Our Enemy": A Qualitative Study of Barriers to Women's HIV Care in Jimma, Southwest Ethiopia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17030833. [PMID: 32013114 PMCID: PMC7036873 DOI: 10.3390/ijerph17030833] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Revised: 01/21/2020] [Accepted: 01/24/2020] [Indexed: 01/08/2023]
Abstract
Evidence exists that suggests that women are vulnerable to negative HIV treatment outcomes worldwide. This study explored barriers to treatment outcomes of women in Jimma, Southwest Ethiopia. We interviewed 11 HIV patients, 9 health workers, 10 community advocates and 5 HIV program managers from 10 institutions using an in-depth interview guide designed to probe barriers to HIV care at individual, community, healthcare provider, and government policy levels. To systematically analyze the data, we applied a thematic framework analysis using NVivo. In total, 35 participants were involved in the study and provided the following interrelated barriers: (i) Availability— most women living in rural areas who accessed HIV cared less often than men; (ii) free antiretroviral therapy (ART) is expensive—most women who have low income and who live in urban areas sold ART drugs illegally to cover ART associated costs; (iii) fear of being seen by others—negative consequences of HIV related stigma was higher in women than men; (iv) the role of tradition—the dominance of patriarchy was found to be the primary barrier to women’s HIV care and treatment outcomes. In conclusion, barriers related to culture or tradition constrain women’s access to HIV care. Therefore, policies and strategies should focus on these contextual constrains.
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Affiliation(s)
- Hailay Gesesew
- Public Health, Flinders University, Adelaide 5042, Australia; (H.G.); (L.M.)
- Epidemiology, College of Health Sciences, Mekelle University, Mekelle, Ethiopia
| | - Pamela Lyon
- Southgate Institute for Health, Society ad Equity, College of Medicine & Public Health, Flinders University, Adelaide 5042, Australia;
| | - Paul Ward
- Public Health, Flinders University, Adelaide 5042, Australia; (H.G.); (L.M.)
- Correspondence: ; Tel.: +61-8-7221-8415
| | | | - Lillian Mwanri
- Public Health, Flinders University, Adelaide 5042, Australia; (H.G.); (L.M.)
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Ilinca S, Di Giorgio L, Salari P, Chuma J. Socio-economic inequality and inequity in use of health care services in Kenya: evidence from the fourth Kenya household health expenditure and utilization survey. Int J Equity Health 2019; 18:196. [PMID: 31849334 PMCID: PMC6918604 DOI: 10.1186/s12939-019-1106-z] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Accepted: 12/09/2019] [Indexed: 11/27/2022] Open
Abstract
Background Kenya is experiencing persistently high levels of inequity in health and access to care services. In 2018, decades of sustained policy efforts to promote equitable, affordable and quality health services have culminated in the launch of a universal health coverage scheme, initially piloted in four Kenyan counties and planned for national rollout by 2022. Our study aims to contribute to monitoring and evaluation efforts alongside policy implementation, by establishing a detailed, baseline assessment of socio-economic inequality and inequity in health care utilization in Kenya shortly before the policy launch. Methods We use concentration curves and corrected concentration indexes to measure socio-economic inequality in care use and the horizontal inequity index as a measure of inequity in care utilization for three types of care services: outpatient care, inpatient care and preventive and promotive care. Further insights into the individual and household level characteristics that determine observed inequality are derived through decomposition analysis. Results We find significant inequality and inequity in the use of all types of care services favouring richer population groups, with particularly pronounced levels for preventive and inpatient care services. These are driven primarily by differences in living standards and educational achievement, while the region of residence is a key driver for inequality in preventive care use only. Pro-rich inequalities are particularly pronounced for care provided in privately owned facilities, while public providers serve a much larger share of individuals from lower socio-economic groups. Conclusions Through its focus on increasing affordability of care for all Kenyans, the newly launched universal health coverage scheme represents a crucial step towards reducing disparities in health care utilization. However in order to achieve equity in health and access to care such efforts must be paralleled by multi-sectoral approaches to address all key drivers of inequity: persistent poverty, disparities in living standards and educational achievement, as well as regional differences in availability and accessibility of care.
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Affiliation(s)
- Stefania Ilinca
- Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland. .,European Centre for Social Welfare Policy and Research, Vienna, Austria.
| | | | - Paola Salari
- Swiss Tropical and Public Health Institute, Basel, Switzerland.,Institute of Pharmaceutical Medicine (ECPM), University of Basel, Basel, Switzerland
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Medicinal Plants Traded in Informal Herbal Medicine Markets of the Limpopo Province, South Africa. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2019; 2019:2609532. [PMID: 31118951 PMCID: PMC6500648 DOI: 10.1155/2019/2609532] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/02/2019] [Accepted: 04/09/2019] [Indexed: 11/18/2022]
Abstract
Trading of herbal medicines generates economic opportunities for vulnerable groups living in periurban, rural, and marginalized areas. This study was aimed at identifying medicinal plant species traded in the Limpopo province in South Africa, including traded plant parts, conservation statutes of the species, and harvesting methods used to collect the species. Semistructured questionnaire supplemented by field observation was used to collect data from owners of 35 informal herbal medicine markets in the Limpopo province. A total of 150 medicinal plant products representing at least 79 plant species belonging to 45 botanical families, mainly the Fabaceae (11.4%), Asteraceae (7.6%), and Hyacinthaceae (6.3%), were traded in the study area. Roots (50.0%), bulbs (19.0%), and bark (16.0%) were the most frequently sold plant parts. Some of the traded species which include Alepidea amatymbica, Bowiea volubilis, Brackenridgea zanguebarica, Clivia caulescens, Dioscorea sylvatica, Elaeodendron transvaalense, Encephalartos woodii, Eucomis pallidiflora subsp. pole-evansii, Merwilla plumbea, Mondia whitei, Prunus africana, Siphonochilus aethiopicus, Synaptolepis oliveriana, and Warburgia salutaris are of conservation concern and listed on the South African Red Data List. Findings of this study call for effective law enforcement to curb illegal removal of wild plants especially those species that are at the verge of extinction.
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Nega SS, Bekele HM, Meles GG, Nordeng H. Medicinal Plants and Concomitant Use with Pharmaceutical Drugs Among Pregnant Women. J Altern Complement Med 2019; 25:427-434. [DOI: 10.1089/acm.2018.0062] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Affiliation(s)
- Selamawit Seid Nega
- Department of Community Medicine and Global Health, Faculty of Medicine, University of Oslo, Oslo, Norway
| | | | | | - Hedvig Nordeng
- PharmacoEpidemiology and Drug Safety Research Group, School of Pharmacy, University of Oslo, Oslo, Norway
- Department of Child Health, Norwegian Institute of Public Health, Oslo, Norway
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Exploring the effects of peri-partum ingestion of traditional medicine on maternal and foetal outcomes: a prospective cohort study. BMC Res Notes 2019; 12:166. [PMID: 30909953 PMCID: PMC6434835 DOI: 10.1186/s13104-019-4199-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Accepted: 03/16/2019] [Indexed: 11/21/2022] Open
Abstract
Objective In Africa, 80% of women ingest traditional medicine (TM) during pregnancy. Although widely used in Cameroon, no study in has either demonstrated its safety or effectiveness. Hence, we sought to determine the effects of TM ingestions during the peri-partum period on maternal and foetal outcomes. A cohort study was conducted from January to April 2016 in two referral maternity departments of Cameroon. We consecutively enrolled all consenting parturients with gestational age above 28 weeks. We divided them into two groups; exposed and unexposed. The exposure studied was ingestion of TM within 72 h prior to delivery. Variables studied were socio-demographic characteristics, type and frequency of TM ingested and details of labour. Results We enrolled a total of 603 parturients of whom 147 in the exposed group and 456 in the non-exposed group. The most frequently used TM were honey and Triumfetta pentandra A. Ingestion of TM in the peri-paritum period was associated with intra-partum vaginal bleeding, dystocic labour, tachysystole and uterine atony. No adverse neonatal outcome was observed. Overall, these findings could help guide the direction of future research into the safety and potential benefits of peri-partum TM use, as well as serving as a preliminary reference for counselling.
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Hume VJ, Wainwright M. Reflections on a field across time and space: the emergent medical and health humanities in South Africa. MEDICAL HUMANITIES 2018; 44:263-269. [PMID: 30482818 DOI: 10.1136/medhum-2018-011475] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/12/2018] [Indexed: 06/09/2023]
Abstract
In this paper, we draw on our own cross-cultural experience of engaging with different incarnations of the medical and health humanities (MHH) in the UK and South Africa to reflect on what is distinct and the same about MHH in these locations. MHH spaces, whether departments, programmes or networks, have espoused a common critique of biomedical dualism and reductionism, a celebration of qualitative evidence and the value of visual and performative arts for their research, therapeutic and transformative social potential. However, there have also been differences, and importantly a different 'identity' among some leading South African scholars and practitioners, who have felt that if MHH were to speak from the South as opposed to the North, they would say something quite different. We seek to contextualise our personal reflections on the development of the field in South Africa over recent years within wider debates about MHH in the context of South African academia and practice, drawing in part on interviews conducted by one of the authors with South African researchers and practitioners and our own reflections as 'Northerners' in the 'South'.
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Affiliation(s)
| | - Megan Wainwright
- Division of Social and Behavioural Sciences, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
- Department of Anthropology, University of Durham, Durham, UK
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Das M, Angeli F, Krumeich AJSM, van Schayck OCP. The gendered experience with respect to health-seeking behaviour in an urban slum of Kolkata, India. Int J Equity Health 2018; 17:24. [PMID: 29444674 PMCID: PMC5813424 DOI: 10.1186/s12939-018-0738-8] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Accepted: 02/06/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Empirical evidence shows that the relationship between health-seeking behaviour and diverse gender elements, such as gendered social status, social control, ideology, gender process, marital status and procreative status, changes across settings. Given the high relevance of social settings, this paper intends to explore how gender elements interact with health-seeking practices among men and women residing in an Indian urban slum, in consideration of the unique socio-cultural context that characterises India's slums. METHODS The study was conducted in Sahid Smriti Colony, a peri-urban slum of Kolkata, India. The referral technique was used for selecting participants, as people in the study area were not very comfortable in discussing their health issues and health-seeking behaviours. The final sample included 66 participants, 34 men and 32 women. Data was collected through individual face-to-face in-depth interviews with a semi-structured questionnaire. RESULTS The data analysis shows six categories of reasons underlying women's preferences for informal healers, which are presented in the form of the following themes: cultural competency of care, easy communication, gender-induced affordability, avoidance of social stigma and labelling, living with the burden of cultural expectations and geographical and cognitive distance of formal health care. In case of men ease of access, quality of treatment and expected outcome of therapies are the three themes that emerged as the reasons behind their preferences for formal care. CONCLUSION Our results suggest that both men and women utilise formal and informal care, but with different motives and expectations, leading to contrasting health-seeking outcomes. These gender-induced contrasts relate to a preference for socio-cultural (women) versus technological (men) therapies and long (women) versus fast (men) treatment, and are linked to their different societal and familial roles. The role of women in following and maintaining socio-cultural norms leads them to focus on care that involves long discussions mixed with socio-cultural traits that help avoid economic and social sanctions, while the role of men as bread earners requires them to look for care that ensures a fast and complete recovery so as to avoid financial pressures.
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Affiliation(s)
- Moumita Das
- School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands. .,Centre for Study of Social Change and Development, Institute for Social and Economic Change (ISEC), Bangalore, India.
| | - Federica Angeli
- Department of Organization Studies, School of Social and Behavioural Sciences, Tilburg University, Tilburg, The Netherlands
| | - Anja J S M Krumeich
- Department of Health Ethics and Society, School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands
| | - Onno C P van Schayck
- Department of General Practice, School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands
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