Assessment Of Socio-Economic Status And The Utilization Of Traditional Herbs In The Treatment Of Malaria Among Pregnant Women

Abstract

This study examined the assessment of socio-economic status and the utilization of traditional herbs in the treatment of malaria among pregnant women in Taura metropolis Jigawa State. Malaria in pregnancy can lead to malaria-related anaemia, a condition that when left untreated, can result in death, especially among vulnerable populations such as pregnant women. Malaria can lead to severe anaemia and maternal and foetal death. This study aimed at exploring the perception and use of traditional medicine in the treatment of malaria among pregnant women in TauraL.G.A, Jigawa state. A descriptive cross-sectional survey method was adopted for the study. Study population was 93 pregnant women purposively selected from Taura L.G.A. Structured questionnaire with reliability coefficient of 0.75 was used for data collection. Health Research Ethics Committee of University of Nigeria Teaching Hospital Jigawa approved the study. Data collection was on the spot and was analysed with SPSS/IBM version 23. Inferential statistics was used to test the significance of income and educational level in determining the use of traditional medicine among pregnant women at p<0.05 level of significance. Majority (93.5%) of pregnant women in Taura used traditional medicine to treat malaria. More than half (87.1%) perceived traditional medicine used in treating malaria as effective. Efforts should be intensified to discourage and reduce to the barest minimum the use of traditional medicines in treating malaria in pregnancy. This will help in stemming the tide of maternal and child mortality and morbidity in these urban slums.

CHAPTER ONE

INTRODUCTION

1.1     Background of the study

Information on health seeking behaviour and health care utilization has important policy implications in health systems development. Factors which influence which treatment sources people seek when symptoms occur include socio-economic status, socio-cultural factors like beliefs and household decision making to seek care, social networks and gender (Okojie, 2015).

A herbal remedy is thus one in which the main therapeutic activity depends on plant or fungi. The pharmacopeia contains at least 25% of drugs derived from herbs and many others which are synthetic analogies built on  prototype compounds isolated form plants  (Arvigo and Balik, 2014). Plant product use covers some important therapeutic categories namely antimalarial, anticancer, antimicrobials, contraceptives, muscle relaxants, purgatives, hematinics, steroids and anesthesia. Advertisement in the mass media in Nigeria is a channel that TM providers often use to propagate spurious claims of “one product cures all”. It is believed that many modern medical practices like physiotherapy have their origin in traditional medical practices.  The psychosomatic method of healing mental disorders used primarily by psychiatrics today is based loosely on ancient traditional medical practice (Sunshine, 2016). To date, TM continues to give birth to modern medicines and medical practices. For instance a tincture of beach morning glory, Ipomoea pescaprace  (convolvulcene) is now certified as an anti  inflammatory treatment (Lewington, 2013).

Malaria is a life threatening parasitic disease transmitted by female Anopheles mosquitoes. In Nigeria, malaria is responsible for around 60% of the out-patient visits to health facilities, 30% of childhood death, 25% of death in children under one year and 11% of maternal deaths (National Population Commission, 2008; Noland et al., 2014). Similarly, about 70% of pregnant women suffer from malaria, which contributes to maternal anemia, low birth weight, still births, abortions and other pregnancy-related complications (Federal Ministry of Health Abuja, 2005).

Presently, malaria remains one of the worst menaces of tropical countries of the world. It is a killer and debilitating disease that affects the physical and economic well-being of people living in endemic areas of Africa (WHO, 2008). Pregnant women are among those in the higher risk group (Okwa, 2003). Recent global estimate shows that there are between 300 – 500million clinical cases of malaria and between 1.50 – 2.70million deaths attributed to malaria annually (Greenwood, 2005). Pregnant women are at immense risk of malaria due to natural immune depression in pregnancy (Fievet, 2008). Hence, it is one of the most important health issues affecting pregnant women as it has a risk of jeopardizing the life of the woman or the fetus (WHO, 2010).

Traditional herbal medicine could be described as “herbs, herbal materials, herbal preparations and finished herbal products whose content includes active ingredients parts of plants, or other plant materials, or combinations”. Herbal medicines can be in the form of liquids, powder, capsules, tablets or ointments. Some are pre-packaged while others are prepared when needed and are used not only to cure illness but to maintain or boost one’s health (WHO, 2002). In Africa, reliance on herbal medicines is relatively high and the global use of herbal medicine is growing. Most pregnant women believe that these medicines are ‘natural’ and ‘safe’ com­pared to modern drugs. Besides, traditional medicine is believed to treat medical problems and improve health status during pregnancy, birth and postpartum care in many rural areas (Khadivzadeh and Ghabel, 2012).

Erhun, Agbani and Adesanya, (2004) opted that many pregnant women that are involved in such practice acquire the knowledge from relatives, neighbours, friends, traditional medicine dealers and sometimes media (Shah, 2004). The situation is predominant due to the limited antenatal health delivery centers and defective functional health institutions (Rohra, 2008); poor medical services and attitude of medical staff; lack of professional control of pharmaceutical products (Abrahams and Jewkes, 2002) as well as high illiteracy level and cost of synthetic malaria medicine over traditional orthodoxones (Dossou-Yov, 2001).

In addition, several factors such as; socioeconomic status of the women, poverty issues, cultural perception, age, sex, income level, religion and belief of certain diseases’ entity and their perceived responses to indigenous medications have been widely reported as indicators that influences their attitude (WHO, 2002); Hence, herbal traditional medication for curing malaria has become a norm and is widely practiced and patronized by pregnant women owing to general ease of access, social and cultural influences, perceived efficacy and beliefs about its safety (Langloid-Klassen, 2007).

Kyomuhendo (2005) noted that pregnant women decisions regarding health and antenatal care attendance are influenced by the patriarchal system of society that gives men control over resources to the disadvantage of women. This study therefore, aims at examining the level of utilization of traditional medicine in the treatment of malaria among pregnant women in Taura metropolis Jigawa State.

1.2     Statement of the Problem

Malaria infection during pregnancy is a major public health problem in tropical and subtropical regions throughout the world and Nigeria in Particular. The burden of malaria infection during pregnancy is caused mainly by Plasmodium falciparum, the most common malaria species in Africa (WHO, 2010). Pregnant women and the unborn children are particularly vulnerable to malaria, which is a major cause of prenatal mortality, low birth weight, and maternal anaemia (Greenwood, 2007). Malaria during pregnancy compounds or provokes anaemia, which, when severe, increases the risk of maternal death (estimated at around 10,000 deaths annually), low birth weight (linked to around 100,000 annual infant deaths in Africa), pre-term delivery, congenital infection and reproductive loss of overwhelming morbidity and mortality (Fakeye, 2009).

There have been a considerable number of reports about poor knowledge, attitudes, and practices among pregnant women relating to malaria and its control from different parts of Africa. The disease remains the world’s most important tropical health challenge. Access to medical care is limited in many malaria-endemic areas and where medical services exist, they commonly lack facilities for laboratory diagnosis, and treatment option. This forces these pregnant women to use various forms of substances and traditional herbs for curing malaria.

1.3     Objectives of the study

The main objective of the study is to examine the assessment of socio-economic status and the utilization of traditional herbs in the treatment of malaria among pregnant womenin Taura metropolis Jigawa State. While, the specific purpose includes;

1. To determine influence of socio-economic status on the use of traditional herbs in the treatment of malaria among pregnant women.
2. To find out the extent to which the age of pregnant women determine the use of traditional herbs for the treatment of malaria.
3. To find out the extent to which the level of education of pregnant women determine the use of traditional herbs for the treatment of malaria.
4. To examine the extent to which the locality of pregnant women determine the use of locally made herbs for treatment of malaria.

1.4     Research Question

The following research questions were raised in this study;

1. What is the difference in socio-economic status on the use of traditional herbs in the treatment of malaria among pregnant women?
2. What is the difference in the ages of pregnant women on the use of traditional herbs for the treatment of malaria?
3. What is the difference in the level of educational background of pregnant women in the use of traditional herbs for the treatment of malaria?
4. What is the difference in the locality of pregnant women in the use of traditional herbs for the treatment of malaria?

1.5     Research Hypotheses

The following null hypotheses were formulated in the study:

H_O1: There is no significant difference between the Socioeconomic status in use of traditional medicine for the treatment of malaria among pregnant women in Taura.

H_O2: There is no significant difference between the age groups in the use of traditional medicine for the treatment of malaria by of pregnant women in Taura.

H_O3: There is no significant difference between the levels of Education in the use of traditional medicine for the treatment of malaria among pregnant women in Taura.

H_O4: There is no significant difference between Urban and Rural areas in the use of traditional medicine for the treatment of malaria by pregnant women in Taura

1.6     Significance of the study

The findings from this study would be useful to the following; pregnant women, ministries of health, parastatals, health sectors, policy makers and government.

Women: the study will help them to develop a positive attitude towards antenatal care and the possible dangers in the use of traditional herbal medicine in malaria prevention and treatment among pregnant women.

Health sectors: Health practitioners would benefit from this study; as it would help them in caring adequately and planning well for pregnant women attending antenatal clinic when treating them for malaria.

Ministries: This study would be of great importance to ministries of health by informing them on the importance of this study is to address the issue concerning the attitude towards the use of traditional herbal medicine for the treatment of malaria among pregnant women attending antenatal care and to organize enlightenment programmes aimed at enhancing the attitudes of pregnant women towards frequent antenatal clinics.

Policy makers: This study will help policy makers to formulate relevant policies on malaria prevention while making informed decisions on the steps to follow in increasing antenatal care attendance levels among pregnant women attending Teaching Hospital in Jigawa State.

Government: This study would be useful to government and parastatals by educating them on the need to provide concerted health education intervention to improve the attitude and knowledge of pregnant women regarding poor health seeking behavior and adequate strategies for malaria prevention especially with the use of insecticide, treated Net, adequate funding, etc. necessary for controlling and reducing incidence of malaria in the general public.

1.7     Scope of the study

The study is delimited in scope to the assessment of socio-economic status and the utilization of traditional herbs in the treatment of malaria among pregnant women in Taura L.G.A,Jigawa State, Nigeria. The researcher would chose this site because it is easily accessible and students are sent there for their clinical experiences and cases are referred from primary and secondary health facilities to the institution for expert management.

1.8     Operational definition of terms

Malaria: Malaria is a serious and sometimes fatal disease caused by a parasite that commonly infects a certain type of mosquito which feeds on humans. People who get malaria are typically very sick with high fevers, shaking chills, and flu-like illness.

Mosquito: A mosquito is any member of a group of about 3,500 species of small insects belonging to the order Diptera (flies). Within Diptera, mosquitoes constitute the family Culicidae (from the Latin culex meaning “gnat”). The word “mosquito” (formed by mosca and diminutive -ito) is Spanish for “little fly”.

Pregnancy: Pregnancy occurs when a sperm fertilizes an egg after it’s released from the ovary during ovulation. The fertilized egg then travels down into the uterus, where implantation occurs. A successful implantation results in pregnancy. On average, a full-term pregnancy lasts 40 weeks.

Traditional medicine: Traditional medicine comprises medical aspects of traditional knowledge that developed over generations within various societies before the era of modern medicine.

Treatment: A treatment is the attempted remediation of a health problem, usually following a diagnosis.

CHAPTER FIVE

CONCLUSION AND RECOMMENDATION

5.1     Conclusion

This study investigated the assessment of socio-economic status and the utilization of traditional herbs in the treatment of malaria among pregnant women. It can be concluded that majority of the pregnant womenin Taura L.G.A use traditional medicine to treat malaria and majority affirmed that traditional medicines used in treating malaria was effective. Also, the perceived reasons for the use of traditional medicine include traditional medicine being more accessible than orthodox medicine, less expensive than orthodox medicine, the belief that traditional medicine will treat the malaria. Therefore, policies and intervention strategies by policymakers should be aimed at addressing the issues of use of traditional medicine in pregnancy by organizing enlightenment programmes that will enhance the attitudes of pregnant women to frequent health centres and clinics for appropriate treatment during antenatal and treatment of any ailment during pregnancy.

5.2     Recommendation

The findings from this study highlights an urgent need for nurses and other health care givers to be aware of this practice and make efforts in obtaining information about herb use during ante natal. There is need to create awareness on the possible side effects occurring from use of traditional medicine in pregnancy. Intervention strategies should be aimed at addressing the issues of use of traditional medicine in pregnancybyorganizing enlighten- mentprogrammes that will enhance the attitudes of pregnant women to frequent health centers and clinics for appropriate treatment to be given to them during antenatal and treatment of any ailment during pregnancy. Adequate care should be provided and given to pregnant women when treating the pregnant women of malaria during antenatal. Orthodox medicine for prevention and treatment malaria should be made available, affordable if possible free and accessible to pregnant women in communities.