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Table 3 Characteristics of studies

From: The use of traditional medicine in maternity care among African women in Africa and the diaspora: a systematic review

Author Participants’ country of origin Sample size Target groups Prevalence of TM use Specific types of TMs used Characteristics of users Maternal conditions treated by TM/ reasons of use Source of information or providers Disclosure of TM use to health care providers Study design/data collection method
Banda et al., 2007 [26] Zambia 1128 Pregnant women 21% NR - Users are not different from non- users in terms of age, education, ethnicity or income
- women who knew anyone who had used TM during pregnancy were more likely to use TM
- Women who thought that the use of TM may hurt their baby were less likely to use TM
- Women who reported accessing traditional medical care were only half as likely to adhere to HIV drugs
NR NR 64% of users did not want to share their use of TM to health care providers Quantitative/Interviewer administered questionnaire
Bayisa et al., 2014 [27] Ethiopia 250 Pregnant women 50.4% Herbal medicine (garlic, ginger, eucalypt, ruta rue) - Age, educational status, marriage, ethnicity and source of information were not associated with TM use
- About 70% of users were pregnant women on their first trimester
For treatment of nausea, morning sickness, vomiting, cough, nutritional deficiency Neighbors, family, health professionals, traditional healers NR Quantitative/ semi-structured questionnaire
Duru et al., 2016 [28] Nigeria 500 Pregnant women and nursing mothers 36.8% Herbal medicine (bitter leaf, palm kernel, bitter kola, neem leaves, garlic, jute leaves, ginger - Pregnant women aged 20–30 years were frequent users (41%)
- Married women were eight times more likely to use TM than unmarried women
- Women with no formal education reported the highest use (85.7%) compared to tertiary education achievers (18.8%)
- Better income favored use of TM
- Gestational period, parity, ethnicity and occupation did not impacted on the use of TM
NR NR NR Quantitative/ semi-structured interview administered questionnaire
Elkhoudri et al., 2016 [29] Morocco 181 Mothers who gave birth in the last 5 years preceding the study 42% Herbal medicine (vervain, cresson, madder, fenugreek, cinnamon, ginger) - Illiterate women have used TM more frequently
- Multiparous women were more likely to use TM than first time mothers
To get back in shape after delivery, facilitate child birth, vomiting, increase breast milk secretion NR NR Quantitative/ interviewer administered questionnaire
Fakeye et al.,2009 [30] Nigeria 595 Pregnant women 67.5 Herbal medicine (detail is not reported) - Age, geographical zones and educational status were strongly associated with TM use (detail description of age category and education level were not reported) Users perceived better effectiveness to TM than conventional medicine, cultural beliefs to TM, better accessibility, lower cost and other reasons were reported Local herb sellers, herbalists 56.6% of participants did not support combining with herbs with medications Quantitative/ structured questionnaire
Kaadaaga et al., 2014 [31] Uganda 260 Women with fertilization problem 76.2 Herbal medicine (detail is not reported) - Married women with infertility problem were more likely to use TM
- women who did not conceived before were more likely to use TM
Women with infertility for less than 3 years were more likely to use TM
Treatment of infertility NR 63.8% of users did not disclose TM use to their physicians Quantitative/interviewer administered structured questionnaire
Lalego et al., 2016 [32] Ethipiopia 363 Pregnant women 73.1 Herbal medicine (ginger, garlic, eucalyptus, ruta rue, ocimumlamifolium, garden cress - being on first trimester, less education and having less knowledge about TM favored use of TM Management of nausea, vomiting, abdominal pain, cold, fever Parents/relatives, neighbor, herbalists NR Quantitative/ interviewer administered structured questionnaire
Mabina et al., 1997 [33] South Africa 577 Pregnant women 43.7 Herbal medicine - Those having knowledge about herbal medicine and on second trimester were frequent users of TM NR Parents, relatives, TBA, herbalist, friends NR Quantitative/ questionnaire
Mbura et al., 1985 [42] Tanzania   Pregnant women 42% Herbal medicine - Prevalence of TM use among pregnant women from the rural and urban areas has no difference
Pregnant women on their first trimester were frequent users
- Muslims were frequent users of TM compared to Christians
To treat pregnancy related symptoms, to assist labor NR NR Quantitative/ interview administered questionnaire
Mothupi and Carol 2014 [7] Kenya 333 Mothers who gave birth in the past 9 months before the study 12% Herbal medicine (detail was not provided) - Women with no formal education were more likely to use TM
- Women who live far from health facilities (>10 km) were frequent users
To treat swollen feet, back pain, digestive problems. High cost, inaccessibility and distance of health facilities resort respondents to TM use Family, friends, open markets, herbal clinics Only 12.5% of user disclosed use of TM to their doctors. About 51% of users reported use of combined herbs with pharmaceutical drugs Quantitative/ interviewer administered questionnaire
Mugomeri et al., 2015 [34] Lesotho 72 Pregnant women 47.2 Herbal medicine (detail was not reported) - 50% of users were on the second trimester
- Women’s age, marital status, literacy and parity were not associated with use of TM
Prevention of abortion, prevention of placenta praevia, promotion of fetal growth, edema, spiritual cleansing and relief of pain Grandmothers, mothers-in-law, TH, TBA NR Quantitative/ semi-structured questionnaire
Mureye et al., 2012 [35] Zimbabwe 248 Pregnant women 52% TM (holy water, soil burrowed by moles, elephant dung, cocktails of unknown herbs, lubricants and others - Being in the age range of 20–25, nulliparity and nulligravidity predicted frequent use of TM
- Most users were on their third trimester
To prevent perineal tearing, placenta retention, breech presentation, postpartum hemorrhage, prolonged labor and preeclampsia NR NR Quantitative/ interviewer administered questionnaire
Nergard et al., 2015 [36] Mali 209 Pregnant women and mothers 79.9% Herbal medicine (Lippia chevalieri, combretum micranthum and others) - Socio-demographic characteristics were not associated with use of herbal medicines
- Frequent use of herbal medicines was reported during the first trimester
For general wellbeing, as dietary supplements, to treat edema, urinary tract infection, and tiredness NR Pregnant women used herbal preparation without any supervision from care providers Quantitative/ interviewer administered questionnaire
Nyeko et al., 2016 [37] Uganda 383 Pregnant women 20% Herbal medicine (detail wan not reported) - Women who used herbal medicine in the past were eight times more likely to use during the current pregnancy
- Distance more than 5 km to health facilities was associated with increased herbal medicine use
To treat waist pain, fever, nausea and vomiting. For induction of labor and difficulty in accessing health facilities. NR 90% of users did not disclose to their health care providers Mixed method / questionnaire survey and FGDs
Orief et al., 2014 [38] Egypt 300 Pregnant women 27.3 Herbal medicine (Aniseed, fenugreek, ginger, garlic, green tea and peppermint) - Statistically significant difference was found regarding the age, gravidity, parity and BMI among the pregnant women who used herbal medicines (details were not reported) To treat abdominal colic during pregnancy, nausea and vomiting and headache Friends, family, physician NR Quantitative/ questionnaire survey
Rasch et al., 2014 [39] Tanzania 125 Women who had unsafe abortion 43% Herbal medicine (Bidens pilosa, rubia cordifolia, ocimum suave and others) - 22% of users ingested medicinal plants orally to induce abortion
- 13% of users inserted plant specimens virginally to induce abortion
- socio-demographic characteristics of users were not reported
To induce abortion NR NR Quantitative/ interviewer administered questionnaire
Sarmiento et al., 2016 [40] Nigeria 5686 Pregnant women in the past 2 years 24.1% NR - Socioeconomic factors were not associated with use of TM To assist childbirth NR NR Quantitative/ interviewer administered questionnaire
Tamuno et al., 2011 [41] Nigeria 500 Pregnant women 31.4% Herbal medicine (ginger, garlic - Women with no formal education were more likely to use TM
- Low socio-economic status was significantly associated with TM use
NR NR Over 40% of women reported combined use of herbs and drugs Quantitative/ self-administered questionnaire
Naidu 2014 [43] South Africa 21 women who were either pregnant or women who had had children NA Isihlambezo (Herbal decoction used by many Zulu women in South Africa as a preventative health tonic during pregnancy) Women’s have a strong cultural belief to Isihlambezo to prevent health problems during pregnancy NA NA NR Qualitative/ interview
Kooi and Theobald 2006 [8] South Africa 27    kgaba (contains different herbal medicines to prevent physical problems and the perceived harm that evil spirits can cause during pregnancy) The use of kgaba as perceived by the women is an important component in the experience of pregnancy and labour NA NA communication about the use of kgaba between pregnant women and health staff was poor Qualitative/interview
  1. NR = not reported; NA = not applicable