Prevalence and factors associated with use of herbal medicines during pregnancy among women attending postnatal clinics in Gulu District, Uganda
Background: According to WHO estimates, 80% of the population living in rural areas in developing countries depends on traditional medicine for their health needs, including use during pregnancy. Despite the fact that knowledge of potential side effects of many herbal medicines in pregnancy is limited and that some herbal products may be teratogenic, data on the extent of use of herbal medicines by women during pregnancy in the study setting is largely unknown. Study objective: To determine the prevalence and factors associated with herbal medicine use during pregnancy among women attending postnatal clinics in Gulu district. Methods: This was a descriptive cross-sectional study which involved 383 women attending postnatal care across four sites in Gulu district using quantitative and qualitative methods of data collection. A structured questionnaire was used to collect quantitative data while qualitative data were obtained using focus group discussions and key informant interviews. The selection of the study participants was by systematic sampling and the main outcome variable was the proportion of mothers who used herbal medicine. Quantitative data was coded and entered into a computerized database using Epidata 3.1. Analysis was done using Statistical Package for Social Scientists version 13, while thematic analysis was used for qualitative data. Results: The prevalence of herbal medicines use during pregnancy was 20.4% (78/383), and was commonly used in the second 23.1% (18/78) and third 20.5% (16/78) trimesters only, second through third trimester 14.1% (11/78), first through second trimester 12.8% (10/78), labour 11.5% (9/78), and first trimester only 10.3% (8/78). The factors significantly associated with use of herbal medicines during pregnancy were perception (OR 2.18, CI 1.02-4.66), and having ever used herbal medicines during previous pregnancy (OR 2.51, CI 1.21-5.19) and for other reasons (OR 3.87, CI 1.46-10.25). The strong preception on the effectiveness, and the widespread background use of herbal medicines was also reflected in the qualitative data as exemplified by the following quote, "I was told that the local herbs are the ones made into modern medicines. I have used local herbs for all my ailments, including during my previous pregnancies and I have not experienced any problems..." FGD, 35 year old mother. Conclusions: The use of herbal medicines during pregnancy among women in Gulu district is common. Perceptions that herbal medicines are effective, and having ever used herbal medicines during previous pregnancy and for other reasons, were associated with use of herbal medicines during pregnancy. Recommendations: The widespread use of herbal medications during pregnancy and the positive attitude towards their use indicates an increased need to educate the population as well as healthcare providers on these issues to advice women not to expose themselves and their unborn babies to the probable risks of herbal preparations.