scholarly journals Understanding forgotten exposures towards achieving Sustainable Development Goal 3: the case of herbal medicine use in Tanzania

2020 ◽  
Author(s):  
Anna Tengia Kessy ◽  
George Chombe Msalale

Abstract Background: In most sub-Sahara African countries, herbal medicines are widely used during pregnancy or delivery for various motives despite their unclear pharmacology and potential toxicity. All risky exposures, including use of herbs during pregnancy or delivery should be restricted in order to facilitate achieving Sustainable Development Goal (SDG) 3, which states: “ensure healthy lives and promote wellbeing for all including reduction of morbidity and mortality among mothers and newborns”. Thus, this study assessed use of herbal medicines during pregnancy or delivery and determined factors associated with the practice in Tabora, Tanzania.Methods: This cross-sectional quantitative study gathered information from 340 women who delivered a live-born baby in the preceding two years. Using a two-stage-sampling technique, we selected and interviewed women attending reproductive, maternal and child health clinics in public health facilities in Tabora, central Tanzania. We compared proportions using chi-square test and performed Poisson regression analysis to determine independent correlates of herbal use.Results: Of 340 recruited women, 208 [61.2 %; 95% confidence interval (CI): 55.4, 66.3%] used herbal medicines during pregnancy or delivery. Major reasons for use included shortening of labour duration, 81 (38.9%) and reducing labour pain, 58 (27.9%). The independent predictors of herbal use were number of antenatal visits and the stance of maternity health care providers on the use of herbs. Women who made less than four visits had 24% higher prevalence ratio of using herbal medicines as compared to those who made at least four visits [adjusted Prevalence Ratio (aPR):1.24; 95%CI: 1.02, 1.50, p=0.03]. Furthermore, the adjusted prevalence ratio of using herbs was 35% higher among women who were not discouraged by health care providers against using herbs versus those who were discouraged (aPR: 1.35; 95%CI: 1.13, 1.60, p=0.01). Conclusions: Use of herbal medicines during pregnancy or delivery among women in Tanzania is high. This calls for comprehensive investigations on the effects of using herbs during pregnancy or delivery as a step towards understanding some of the challenges in achieving SDG 3. Additionally, maternity health care providers ought to strengthen provision of health education messages during antenatal visits on the undesirable effects of using herbs.

2020 ◽  
Author(s):  
Anna Tengia Kessy ◽  
George Chombe Msalale

Abstract Background: In most sub-Sahara African countries, herbal medicines are widely used during pregnancy or delivery for various motives despite their unclear pharmacology and potential toxicity. All risky exposures, including use of herbs during pregnancy or delivery should be restricted in order to facilitate achieving the Sustainable Development Goal (SDG) 3: “ensure healthy lives and promote wellbeing for all including reduction of morbidity and mortality among mothers and newborns”. This study assessed use of herbal medicines during pregnancy or delivery and determined factors associated with the practice in Tabora, Tanzania.Methods: This cross-sectional quantitative study gathered information from 340 women who delivered a live-born baby in the preceding two years. Using a two-stage-sampling technique, we selected and interviewed women attending reproductive, maternal and child health clinics in public health facilities in Tabora, central Tanzania. We compared proportions using chi-square test and performed a Poisson regression analysis to determine independent correlates of herbal use.Results: Of 340 recruited women, 208 (61.2 %; 95%CI: 55.4, 66.3%) used herbal medicines during pregnancy or delivery. Major reasons for use included shortening of labour duration, 81 (38.9%) and reducing labour pain, 58 (27.9%). The independent predictors of herbal use were number of antenatal visits and the stance of maternity health care providers on the use of herbs. Women who made less than four visits had 24% higher prevalence ratio of using herbal medicines as compared to those who made at least four visits (aPR:1.24; 95%CI: 1.02, 1.50, p=0.03). Furthermore, the adjusted prevalence ratio of using herbs was 35% higher among women who were not discouraged by the health care providers against using herbs versus those who were discouraged (aPR: 1.35; 95%CI: 1.13, 1.60, p=0.01). Conclusions: Use of herbal medicines during pregnancy or delivery in Tanzania is high. This calls for comprehensive investigations on the effects of using herbs during pregnancy or delivery as a step towards understanding some of the challenges in achieving SDG 3. Additionally, maternity health care providers ought to strengthen provision of health education messages during antenatal visits on the undesirable effects of using herbs.


2020 ◽  
Author(s):  
Anna Tengia Kessy ◽  
George Chombe Msalale

Abstract Background: In most sub-Sahara African countries, herbal medicines are widely used during pregnancy and labour for various motives despite their unclear pharmacology and potential toxicity. Considering the United Nations Sustainable Development Goal (SDG) 3, exposure to herbs during pregnancy should be restricted in order to safeguard the health of mothers and newborns. This study aimed to assess the proportion of mothers using herbal medicines during pregnancy and delivery and to determine factors associated with the practice.Methods: This cross-sectional quantitative study gathered information from 340 mothers who delivered a live baby in the preceding two years. Using a two-stage-sampling technique, we selected and interviewed mothers attending reproductive, maternal and child health clinics in Tabora, in central Tanzania. We compared proportions using chi-square test and performed a Poisson regression analysis to determine independent correlates of herbal use.Results: Over 60% of mothers in Tabora used herbal medicines during pregnancy and delivery. Major reasons for use were shortening of labour duration, 81 (38.9%) and reducing labour pain, 58 (27.9%). Independent factors of herbal use were distance to the nearest health facility, adjusted prevalence ratio (aPR = 1.12, 95%CI = 1.00,1.25), perception of herbs as safe, (aPR = 1.16, 95%CI = 1.05,1.29) and health care providers’ stance on the use of herbs, (aPR = 1.14, 95%CI = 1.04,1.25).Conclusions: Use of herbal medicines during pregnancy and delivery in Tanzania is high. This calls for comprehensive investigations on the effects of herbs used during pregnancy and delivery as a step towards understanding contributions of forgotten exposures en route for achieving SDG 3. Additionally, health care providers ought to include health education messages during antenatal visits on the undesirable effects of using herbs.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Anna Tengia-Kessy ◽  
George Chombe Msalale

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.


2020 ◽  
Author(s):  
Anna Tengia Kessy ◽  
George Chombe Msalale

Abstract Background In most of sub-Sahara African countries, herbal medicines are widely used during pregnancy and labor for various motives despite their unclear pharmacology and potential toxicity. Considering the Sustainable Development Goals, exposure to herbs during pregnancy should be restricted to safeguard the health of mothers and newborns. Thus, this study aims to assess the proportion of mothers using herbal medicines during pregnancy and delivery and to determine factors associated with the practice.Methods We used an interview schedule to gather information among 340 mothers who delivered a live baby in the preceding two years. Using a two-stage-sampling technique, we selected and interviewed mothers at the health facilities. We compared proportions using chi-square test. We performed a Poisson logistic regression analysis to determine independent predictors of herbal use.Results Over 60% of mothers in Tabora municipality used herbal medicines during pregnancy and delivery. Major reasons for use were shortening of labor duration, 81 (38.9%) and reducing labor pain, 58 (27.9%). Independent predictors of herbal use were distance to the nearest health facility, adjusted prevalence ratio [aPR = 1.12, 95%CI = 1.00,1.25], perception of safety about herbs, [aPR = 1.16, 95%CI = 1.05,1.29] and health care providers stance on the use of herbs, [aPR = 1.14, 95%CI = 1.04,1.25].Conclusion Use of herbal medicine during pregnancy and delivery in Tanzania is high. Researchers should consider designing comprehensive investigations on adverse effects of herbs to the mother and the fetus. Furthermore, health care providers ought to include health education messages during antenatal visits on the undesirable effects of using herbs.


2014 ◽  
Vol 4 (3) ◽  
pp. 191-201 ◽  
Author(s):  
Kristen Choi ◽  
Julia S. Seng

BACKGROUND: Posttraumatic stress disorder (PTSD) affects 8% of pregnant women, and the biggest risk factor for pregnancy PTSD is childhood maltreatment. The care they receive can lead to positive outcomes or to retraumatization and increased morbidity. The purpose of this study is to gather information from a range of clinicians about their continuing education needs to provide perinatal care to women with a maltreatment history and PTSD.METHOD: Maternity health care professionals were interviewed by telephone. Network sampling and purposive sampling were used to include physicians, nurse practitioners, midwives, nurses, and doulas (n = 20), and results were derived from content analysis.RESULTS: Most providers received little or no training on the issue of caring for women with a history of childhood maltreatment or PTSD during their original education but find working with this type of patient rewarding and wish to learn how to provide better care. Providers identified a range of educational needs and recommend offering a range of formats and time options for learning.CONCLUSIONS: Maternity health care providers desire to work effectively with survivor moms and want to learn best practices for doing so. Thus, educational programming addressing provider needs and preferences should be developed and tested to improve care experiences and pregnancy outcomes for women with a history of trauma or PTSD.


2014 ◽  
Vol 4 (1) ◽  
pp. 25-38
Author(s):  
Alissa D. Koski ◽  
Ellie Mirzabagi ◽  
Patience Cofie ◽  
Vandana Tripathi

PURPOSE: Uterotonic drugs, administered immediately after delivery, can prevent postpartum hemorrhage (PPH). As programs expand uterotonic access in settings of high maternal mortality, it is important to understand why and how these drugs are currently used. This qualitative study aimed to describe Ghanaian health care providers’ and community members’ knowledge, perceptions, and practices of uterotonic usage at or near labor and delivery.METHODS: In-depth interviews were conducted in 3 districts with 185 physicians, medical assistants, midwives, nurses, new mothers, mothers aged 50 years and older, traditional birth attendants, and chemists.FINDINGS: Providers described using misoprostol most commonly for labor induction, oxytocin for labor augmentation and PPH prevention, and ergometrine for PPH treatment. Unsafe practices and knowledge gaps were identified regarding labor augmentation and uterotonic storage. Community members reported experience with uterotonics in facility deliveries. Community-based use of pharmaceutical uterotonics was rarely reported, except misoprostol for pregnancy termination; however, community members described use of herbal medicines for intended uterotonic effect. Across respondent categories, uterotonics were more commonly associated with accelerating delivery than PPH prevention.CONCLUSION: Programs promoting facility childbirth and/or uterotonic coverage at home births should consider these underlying patterns of use and encourage safe practices through provider and community engagement.


Author(s):  
AMAD M. AL-AZZAWI ◽  
NEHAD MEHDI ◽  
ALYAA G. AL-JUBOORI ◽  
ANAM EJAZ ◽  
HANEEN ALI ◽  
...  

Objective: The aim of this study was to assess the perceptions of different healthcare professionals towards HM. Methods: The 16-item questionnaire on the belief of health care professionals in herbal medicine was designed by the interdisciplinary task force. Eligible participants were health care providers who were English-and Arabic-literate. The response rate was 78% of participants (781 of 1000) were respondents. In total, 553 out of 781 (71%) participants indicated that they had previously used herbal medicines. The remaining 228 participants did not believe in herbal medicine due to lack of scientific evidence, ineffectiveness and other reasons. Results: The findings of this study indicate that health care professionals including pharmacists believe they have a responsibility to provide information on HM to their patients. However, the current consensus among the respondents is that current HM-focused knowledge is inadequate for such an application. Conclusion: Health care professionals believe in using HM for their needs and have a responsibility to provide information on HM to their patients.


Author(s):  
Samuel Mills ◽  
Jane Kim Lee ◽  
Bahie Mary Rassekh

Abstract A complete civil registration and vital statistics system is the best source of data for measuring most of the Sustainable Development Goal 3 indicators. However, civil registration does not include migration data, which are necessary for calculating the actual number of people living in a given area and their characteristics such as age and sex. This information is needed to facilitate planning, for example, for school places, health care, infrastructure, etc. It is also needed as the denominator for the calculation of a range of health and socioeconomic indicators. Obtaining and using these data can be particularly beneficial for measuring and achieving universal health coverage (Target 3.8), because civil registration can help to identify persons in need of health care and enable decision-makers to plan for the delivery of essential services to all persons in the country, including the most disadvantaged populations. By assigning unique identification numbers to individuals, for example, at birth registration, then using these numbers to link the individuals’ data from civil registration, national identification, and other functional registers, including registers for migration and health care, more accurate and disaggregated population values can be obtained. This is also a key to improving the effectiveness of and access to social services such as education, health, social welfare, and financial services. When civil registration system in a country is linked with its national identification system, it benefits both the government and its citizens. For the government, having reliable and up-to-date vital events information on its citizens supports making informed program and policy decisions, ensuring the accurate use of funds and monitoring of development programs at all levels. For individuals, it makes it easier to prove one’s identity and the occurrence of vital events to claim public services such as survivor benefits or child grants.


2011 ◽  
Vol 20 (1) ◽  
pp. 45-53 ◽  
Author(s):  
Christine Abbyad ◽  
Trina Reed Robertson

Preparation for birthing has focused primarily on Caucasian women. No studies have explored African American women’s birth preparation. From the perceptions of 12 African American maternity health-care providers, this study elicited perceptions of the ways in which pregnant African American women prepare for childbirth. Focus group participants answered seven semistructured questions. Four themes emerged: connecting with nurturers, traversing an unresponsive system, the need to be strong, and childbirth classes not a priority. Recommendations for nurses and childbirth educators include: (a) self-awareness of attitudes toward African Americans, (b) empowering of clients for birthing, (c) recognition of the role that pregnant women’s mothers play, (d) tailoring of childbirth classes for African American women, and (e) research on how racism influences pregnant African American women’s preparation for birthing.


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