AccScience Publishing / IJPS / Volume 0 / Issue 0 / DOI: 10.36922/ijps.0296
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RESEARCH ARTICLE

Information sources and factors influencing the use of herbal medicine among women during pregnancy and childbirth in rural Lilongwe, Malawi: A qualitative study

Dziwenji Makombe1 Alexander Mboma2* Elias Mwakilama3 Kondwani Joseph Banda4,5
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1 Department of Community Health Nursing, Kamuzu University of Health Sciences, Lilongwe, Malawi
2 Department of Midwifery, Kamuzu University of Health Sciences, Lilongwe, Malawi
3 School of Natural and Applied Sciences, University of Malawi, Zomba, Malawi
4 School of Nursing, College of Nursing, Taipei Medical University, Taiwan Province of China
5 Department of Surgery, Endoscopy Unit, Kamuzu Central Hospital, Lilongwe, Malawi
Submitted: 27 February 2023 | Accepted: 25 August 2023 | Published: 28 November 2023
© 2023 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution -Noncommercial 4.0 International License (CC BY-NC 4.0) ( https://creativecommons.org/licenses/by-nc/4.0/ )
Abstract

Existing literature shows increased use of herbal medicine during pregnancy, childbirth, and when tackling associated problems among Malawian women. Beyond Malawi, herbal medicine use is also common among women during pregnancy and childbirth in other parts of the world. However, little is known about the precise information sources and factors that affect women’s use of herbal medicine in Malawi, especially in rural areas where it is commonly practiced. This study aimed at exploring information sources and understanding factors that influence herbal medicine use during pregnancy and childbirth among women living in the rural Lilongwe, Malawi. This is a qualitative descriptive study on 28 female participants purposively identified from four villages (Kagona, Champsinja, Mthupi, and Manja) of Traditional Authority Malili in rural Lilongwe, Malawi. Data were collected from four focus group discussions, with each group consisting of 6 – 8 women, and their discussions were transcribed and analyzed using content analysis method. The findings indicated that previous obstetric experiences (negative and positive), quick relief from labor pain, hastened delivery process, fear of abandonment by guardian during childbirth, and encouragement from peers (friends) are key factors influencing herbal medicine use in rural Lilongwe. We also found that peers (friends), parents, and traditional birth attendants are major sources of information regarding herbal medicine use in Malawi. This study concludes that herbal medicine use during pregnancy and childbirth in rural Malawi is largely influenced by previous labor experiences and fears of being abandoned during labor and childbirth, and that information on herbal medicine use is often sourced from peers, parents, and traditional birth attendants. Thus, this study sheds light on how the community-led pathways can be exploited to influence the decisions to use herbal medicine among women in the rural areas of Malawi.

Keywords
Pregnant women
Herbal medicine
Information source
Pregnancy and childbirth traditional birth attendants
Obstetrics
Funding
Malawi Ministry of Education (MoE)
References

Adejoh, S.O., Alabi, T.A., Osazuwa, P., & Olufeyisan, M.A. (2020). Fear of caesarean section, infertility and utilization of traditional birth attendant among ever-pregnant women in Obafemi-Owode, Ogun State, Niger. African Journal of Social Work, 10(2):32-41.

 

Attah, A.F., O’Brien, M., Koehbach, J., Sonibare, M.A., Moody, J.O., Smith, T.J., et al. (2012). Uterine contractility of plants used to facilitate childbirth in Nigerian ethnomedicine. Journal of Ethnopharmacology, 143(1):377-382. https://doi.org/10.1016/j.jep.2012.06.042

 

Balbontín, Y.M., Stewart, D., Shetty, A., Fitton, C.A., & McLay, J.S. (2019). Herbal medicinal product use during pregnancy and the postnatal period: A systematic review. Obstetrics and Gynecology, 133(5):920-932. https://doi.org/10.1097/aog.0000000000003217

 

Barnes, J. (2003). Quality, efficacy and safety of complementary medicines: Fashions, facts and the future. Part I. Regulation and quality. British Journal of Clinical Pharmacology, 55(3):226-233. https://doi.org/10.1046/j.1365-2125.2003.01810.x

 

Barnes, L.A., Barclay, L., McCaffery, K., & Aslani P. (2019). Complementary medicine products: Information sources, perceived benefits and maternal health literacy. Women and Birth, 32(6):493-520. https://doi.org/10.1016/j.wombi.2018.11.015

 

Bradshaw, C., Atkinson, S., & Doody O. (2017). Employing a qualitative description approach in health care research. Global Qualitative Nursing Research, 4. https://doi.org/10.1177/2333393617742282

 

Butts, J.B., & Rich, K.L. (2011). Philosophies and Theories for Advanced Nursing Practice. London: Jones and Bartlett Learning.

 

Cheptum, J.J., Gitonga, M.M., Mutua, E.M., Mukui, S.J., Ndambuki, J.M., & Koima, W.J. (2017). Perception about traditional birth attendants by men and women of reproductive age in rural Migori county, Kenya. International Journal of Africa Nursing Sciences, 7:55-61. https://doi.org/10.1016/j.ijans.2017.07.002

 

Dante, G., Pedrielli, G., Annessi, E., & Facchinetti, F. (2013). Herb remedies during pregnancy: A systematic review of controlled clinical trials. The Journal of Maternal-Fetal and Neonatal Medicine, 26(3):306-312. https://doi.org/10.3109/14767058.2012.722732

 

Ekor, M. (2014). The growing use of herbal medicines: Issues relating to adverse reactions and challenges in monitoring safety. Frontiers in Pharmacology, 4:177. https://doi.org/10.3389/fphar.2013.00177

 

El Hajj, M., & Holst, L. (2020). Herbal medicine use during pregnancy: A review of the literature with a special focus on Sub-Saharan Africa. Front Pharmacology, 11:866. https://doi.org/10.3389/fphar.2020.00866

 

El Hajj, M., Sitali, D.C., Vwalika, B., & Holst, L. (2020). “Back to Eden”: An explorative qualitative study on traditional medicine use during pregnancy among selected women in Lusaka province, Zambia. Complementary Therapies in Clinical Practice, 40:101225. https://doi.org/10.1016/j.ctcp.2020.101225

 

Forster, D.A., Denning, A., Wills, G., Bolger, M., & McCarthy, E. (2006). Herbal medicine use during pregnancy in a group of Australian women. BMC Pregnancy and Childbirth, 6(1):21. https://doi.org/10.1186/1471-2393-6-21

 

Frawley, J., Adams, J., Sibbritt, D., Steel, A., Broom, A., & Gallois, C. (2013a). Prevalence and determinants of complementary and alternative medicine use during pregnancy: Results from a nationally representative sample of Australian pregnant women. Australian and New Zealand Journal of Obstetrics and Gynaecology, 53(4):347-352. https://doi.org/10.1111/ajo.12056

 

Gardiner, P., Graham, R., Legedza, A.T., Ahn A.C., Eisenberg, D.M., & Phillips R.S. (2007). Factors associated with herbal therapy use by adults in the United States. Alternative Therapies in Health and Medicine, 13(2):22-29.

 

Glanz, K., & Rimer, B.K. (2005). Theory at a Glance: Applications to Health Promotion and Health Behaviour. (NIH Pub. No. 05-3896). 2nd ed. Washington, D.C.: National Cancer Institute, National Institutes of Health, U.S. Department of Health and Human Services.

 

Hall, H.G., Griffiths, D.L., & McKenna, L.G. (2011). The use of complementary and alternative medicine by pregnant women: A literature review. Midwifery, 27(6):817-824. https://doi.org/10.1016/j.midw.2010.08.007

 

Holroyd, E., Zhang, A.L., Suen, L.K., & Xue, CC. (2008). Beliefs and attitudes towards complementary medicine among registered nurses in Hong Kong. International Journal of Nursing Studies, 45(11):1660-1666. https://doi.org/10.1016/j.ijnurstu.2008.04.003

 

Holst, L., Wright, D., Nordeng, H., & Haavik, S. (2009). Use of herbal preparations during pregnancy: Focus group discussion among expectant mothers attending a hospital antenatal clinic in Norwich, UK. Complementary Therapies in Clinical Practice, 15(4):225-229. https://doi.org/10.1016/j.ctcp.2009.04.001

 

Hsieh, H.F., & Shannon, S.E. (2005). Three approaches to qualitative content analysis. Qualitative Health Research, 15(9):1277-1288. https://doi.org/10.1177/1049732305276687

 

Ibanda, H.A., Ntuyo, P., Mubiru, F., & Namusoke, F. (2021). Prevalence and factors associated with use of herbal medicine among pregnant women in an urban tertiary hospital in Uganda-a cross-sectional survey. East and Central African Journal of Pharmaceutical Sciences, 24(2):78-84.

 

Kennedy, D.A., Lupattelli, A., Koren, G., & Nordeng, H. (2013). Herbal medicine use in pregnancy: Results of a multinational study. BMC Complementary and Alternative Medicine, 13:355. https://doi.org/10.1186/1472-6882-13-355

 

Khadivzadeh, T., & Ghabel, M. (2012). Complementary and alternative medicine use in pregnancy in Mashhad, Iran, 2007-8. Iranian Journal of Nursing and Midwifery Research, 17(4):263-269.

 

Lampiao, F., Maliwichi-Nyirenda, C., Mponda, J., Tembo, L., & Clements, C. (2018a). A preliminary investigation of the effects of labour inducing plant, Cissampelos mucronata, on the outcomes of pregnancy using rat models. Malawi Medical Journal, 30(3):159-161. https://doi.org/10.4314/mmj.v30i3.5

 

Laor, T. (2022). Radio on demand: New habits of consuming radio content. Global Media and Communication, 18(1):25-48. https://doi.org/10.1177/17427665211073868

 

Makombe, D., Thombozi, E., Chilemba, W., Mboma, A., Banda, K.J., & Mwakilama E. (2023). Herbal medicine use during pregnancy and childbirth: Perceptions of women living in Lilongwe rural, Malawi-a qualitative study. BMC Womens Health, 23(1):228. https://doi.org/10.1186/s12905-023-02387-z

 

Miles, A. (1998). Radio and the commodification of natural medicine in Ecuador. Social Science and Medicine, 47(12):2127-2137. https://doi.org/10.1016/s0277-9536(98)00276-7

 

Mkize, G.T. (2015). An Assessment of Use of Traditional Medicine in Pregnacy and Associated Factors among Black South African Women Delivering in Bertha Gxowa Hospital. Available from: https://hdl.handle.net/10539/17340 [Last accessed on 2023 Feb 23].

 

Mothupi, M.C. (2014). Use of herbal medicine during pregnancy among women with access to public healthcare in Nairobi, Kenya: A cross-sectional survey. BMC Complementary and Alternative Medicine, 14(1):432. https://doi.org.10.1186/1472-6882-14-432

 

Mudonhi, N., & Nunu, WN. (2020). Traditional and health practitioners perspective on traditional medicine utilisation during antenatal care in Bulilima, Plumtree, Zimbabwe. Available: https://www.researchsquare.com [Last accessed on 2023 Nov 24].

 

Mugomeri, E., Chatanga, P., Seliane, K., & Maibvise, C. (2015). Identifying promoters and reasons for medicinal herb usage during pregnancy in Maseru, Lesotho. Africa Journal of Nursing and Midwifery, 17(1):4-16. https://doi.org/10.25159/2520-5293/63

 

Ngoma, C.M., & Siachapa, B. (2017). Use of herbal medicines to induce labour by pregnant women: A systematic review of literature. JOJ Nursing and Health Care, 2(3):555-590. https://doi.org/10.19080/jojnhc.2017.02.555590

 

Nyeko, R., Tumwesigye, N.M., & Halage, AA. (2016). Prevalence and factors associated with use of herbal medicines during pregnancy among women attending postnatal clinics in Gulu district, Northern Uganda. BMC Pregnancy and Childbirth, 16(1):296. https://doi.org/10.1186/s12884-016-1095-5

 

Ong, C.O., Chan, L.Y., Yung, P.B., & Leung, T.N. (2005). Use of traditional Chinese herbal medicine during pregnancy: A prospective survey. Acta Obstetricia Et Gynecologica Scandinavica, 84(7):699-700. https://doi.org/10.1111/j.0001-6349.2005.00659.x

 

Panganai, T., & Shumba, P. (2016). The African pitocin-a midwife’s dilemma: The perception of women on the use of herbs in pregnancy and labour in Zimbabwe, Gweru. The Pan African Medical Journal, 25:9. https://doi.org/10.11604/pamj.2016.25.9.7876

 

Peprah, P., Agyemang-Duah, W., Arthur-Holmes, F., Budu, H.I., Abalo, E.M., Okwei, R., et al. (2019). ‘We are nothing without herbs’: A story of herbal remedies use during pregnancy in rural Ghana. BMC Complementary and Alternative Medicine, 19(1):65. https://doi.org/10.1186/s12906-019-2476-x

 

Quzmar, Y., Istiatieh, Z., Nabulsi, H., Zyoud, S.H., & Al-Jabi, S.W. (2021). The use of complementary and alternative medicine during pregnancy: A cross-sectional study from Palestine. BMC Complementary and Alternative Medicine, 21(1):108. https://doi.org/10.1186/s12906-021-03280-8

 

Sandelowski, M. (2000). Whatever happened to qualitative description? Research in Nursing and Health, 23(4):334-340. https://doi.org/10.1002/1098-240x(200008)23:4<334::aid-nur9>3.0.co;2-g

 

Sripad, P., Kirk, K., Adoyi, G., Dempsey, A., Ishaku, S., & Warren, CE. (2019). Exploring survivor perceptions of pre-eclampsia and eclampsia in Nigeria through the health belief model. BMC Pregnancy and Childbirth, 19(1):431. https// doi.org/10.1186/s12884-019-2582-2

 

Tsui, B., Dennehy, C.E., & Tsourounis, C. (2001). A survey of dietary supplement use during pregnancy at an academic medical center. American Journal of Obstetrics and Gynecology, 185(2):433-437. https://doi.org/10.1067/mob.2001.116688

 

World Health Organization. (2017). Report of the Consultation Meeting on Quality Control of Herbal Medicine, 1010, 2018. WHO Technical Report. Hong Kong. Available from: https://cdn.who.int/media/docs/default-source/medicines/ norms-and-standards/guidelines/production/trs1010- annex1-herbal-processing.pdf?sfvrsn=80b60ae5 [Last accessed on 2023 Feb 26].

Conflict of interest
The authors have no conflicts of interest to declare.
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