Factors influencing traditional herbal medicine use during pregnancy among women attending health facilities; case study: Mpigi District

Abstract

Introduction Traditional herbal medicine is common, and WHO estimates its use in developing countries at about 80%, including use during pregnancy. Despite documented adverse outcomes secondary to, or aggravated by use of herbal medicines, its use during pregnancy has remained high. This high prevalence of herbal medicinal use during pregnancy is believed to be a contributing factor to poor maternal and new born outcomes in Uganda and other developing countries. The factors that influence use of herbal medicinal use during pregnancy have not been elaborately studied, and this hampers efforts to limit their use. Methods A cross-sectional mixed methods study was conducted in Mpigi District Central Uganda, targeting post-natal mothers attending the health facilities for the various post-natal services. The objectives were to determine the prevalence of herbal medicine use during pregnancy and to describe socio-cultural and health system factors that influence herbal medicine use during pregnancy. A semi-structured pre-tested coded questionnaire was administered for quantitative research. Two focused group discussions and four key informant interviews were conducted for qualitative data. A modified poisson regression model was used to find out factors that are significantly associated with herbal medicine use during pregnancy and variables whose p-value of the crude prevalence ratios was less than 0.05 were considered for multivariable analysis. Results Results of the study showed that the prevalence of herbal medicinal use during pregnancy was 79% with the commonest herbal preparation being mumbwa. Several factors were identified to independently influence herbal medicinal use during pregnancy and these were costly health care, availability of traditional birth attendants in communities, Tradition of use of herbal medicines, and perceived safety and efficacy of the herbal medicines. Conclusions and Recommendations Use of herbal medicines in pregnancy is still high and this is majorly influenced by expensive/costly health services to the communities and availability of trusted traditional birth attendants in communities. There is need to develop innovative health financing mechanisms, like the proposed National Health Insurance Scheme, to solve the challenge of costly health care to communities, and also need to train traditional birth attendants and integrate them into the mainstream health care system as community linkage or referral agents.