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Health system factors influencing traditional herbal medicine use during pregnancy amongst women in Mpigi District, Central Uganda

Criscent Tumuhaise, Richard Kabanda, Miisa Nanyingi, Arthur Kiconco


An estimated 80% of the population in developing countries is dependent on traditional medicine for their health needs, including use during pregnancy despite limited knowledge of potential side effects including teratogenicity. Controlling use of traditional medicines during pregnancy requires understanding the driving factors. This study aimed at determining the health system factors that influence traditional herbal medicine use during pregnancy in a Ugandan setting. A cross-sectional study was conducted among 315 post-partum women obtained by random sampling from post-natal clinics of health facilities in Mpigi District after informed consent. We carried out concurrent triangulation by conducting two focused group discussions of 10 post-natal mothers each, and four Key informant interviews. Quantitative Data analysis involved descriptive statistics and logistic regression analysis. Qualitative data was analyzed by thematic content analysis and presented as narratives. Prevalence of herbal medicine use during pregnancy was 79% (95% Confidence Interval (CI) 68.1% – 86.9%), mainly consumed through oral route (96%). Costly health care adjusted Prevalence Ratio (aPR) 1.61 (95% CI 1.02-2.53), p-value 0.042, and presence and influence of Traditional Birth Attendants aPR 1.21(95% CI 1.05-1.41), p-value 0.011 were significantly associated with use of traditional herbal medicines during pregnancy. Use of traditional herbal medicines is driven by the high costs of quality health care and influence from Traditional Birth Attendants. Innovations in health financing should be promoted and Traditional Birth Attendants should be sensitized and incorporated in the mainstream health care system as community referral agents. (Afr J Reprod Health 2021; 25[6]: 88-98).

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World Health Organization (WHO), 2002. WHO traditional medicine strategy 2002–2005. Geneva.

World Health Organisation, 2016. Traditional Medicine; 12-01.

Complementary Medicines explained, 2021, NPS MedicineWise. Available at;

Nordeng H, Bayne K, Havnen GC and Paulsen BS. Use of herbal drugs during pregnancy among 600 Norwegian women in relation to concurrent use of conventional drugs and pregnancy outcome. Complement Therapy Clinical Practices, 2011 issue 17, Vol 3 pg 147–151.

Nikolajsen T, Nielsen F, Rasch V, Sørensen PH, Ismail F, Kristiansen U and Jäger AK. Uterine contraction induced by Tanzanian plants used to induce abortion. Journal of Ethnopharmacology. 2011 Issue 137 vol 1: pg 921–5

Earnest E. Herbal medicinal products during pregnancy: are they safe? British Journal of Obstetrics and Gynaecology. Issue 109: 2002 pg 227–35.

Seely D, Dugoua JJ, Perri D, Mills E and Koren G. Safety and efficacy of panax ginseng during pregnancy and lactation. Canadian Journal of Clinical Pharmacology; 2008 15(1): pg 87–94.

Dugoua JJ, Perri D, Seely D, Mills E and Koren G. Safety and efficacy of cohosh (caulophyllum thalictroides) during pregnancy and lactation. Canadian Journal of Clinical Pharmacology; 2008 15(1):e66–73.

Cuzzolin L, Zaffani S, Murgia V, Gangemi M, Meneghelli G, Chiamenti G and Benoni G. Patterns and perceptions of complementary/alternative medicine among paediatricians and patients’ mothers: a review of the literature. European Journal of Pediatrics. 2003;162(12):820–7. Epub 2003 sep 26.

Conover EA. Herbal agents and over the counter medications in pregnancy. Best Practices Research in Clinical Endocrinology and Metabolism. 2003; 17(2) pg 237-251

Tabatabace, M. Use of herbal medicine among pregnant women referred to Valiasr Hospital in Kazeroon, Fars, South of Iran. Journal of Medicinal Plants; 2011 10(37):96–108.

Farah MH, Edwards R, Lindquist M, Leon M and D Shaw. International monitoring of adverse health effects associated with herbal medicines. Pharmacoepidemiology of Drug Safety; 2000 9(2):105–12

Juliana Y, Zaleha AM and Rushdan MN. Use of complementary and alternative medicine in pregnancy and its impact on obstetric outcome. Complementary Therapies in Clinical Practice, 2016 25:155-163

Chan LY, Chiu PY and Lau TK. An in-vitro study of guisenoside Rb1-induced teratogenicity using a whole rat embryo culture model. Journal of Human Reproduction; 2003 18:2166–8.

Gruber CW and O’Brien M. Uterotonic plants and their bioactive constituents. Journal of Plant Medicine; 2011 77(3):207–20.

Adams C and Cannel S. Women’s beliefs about “natural” hormones and natural hormones replacement therapy. Menopause; 2001 8(6):433–40.

Uganda Bureau of Statistics 2016. Uganda Demographic and Health Survey report.

Kiguba R, Ononge S, Karamagi C and Sheila M. Herbal medicine use and linked suspected adverse drug reactions in a prospective cohort of Ugandan inpatients. BMC Complementary and Alternative Medicine 2016 16:145.

World Health Organization, 2008. Traditional medicine Fact sheet N°134, Accessed 19 Dec 2018.

Tamuno I, Omole-Ohonsi A and Fadare J. Use of herbal medicine among pregnant women attending a tertiary hospital in northern Nigeria. International Journal of Gynecology and Obstetrics. 2011 Vol. 15, issue 2.

Titilayo OK, Rasaq A and Ismail EM. Attitude and use of herbal medicines among pregnant women in Nigeria. BMC Complementary and Alternative Medicine; 2009 issue 9: pg 53

Nyeko R, Tumwesigye NM and Halage AA. 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 2016 Vol. 16: pg296

Kennedy AD, Lupattelli A, Koren G and Nordeng H. Herbal medicine use in pregnancy: results of a multinational study; BioMedCentral Complementary and Alternative Medicine, 2013 issue 13: page 355 available at

Mpigi District Annual Performance report, 2018.

Gharoro EP and Igbafe AA. Pattern of drug use amongst antenatal patients in Benin City, Nigeria. Medical Scientific Monitoring; 2000 issue 6: pg 84-7.

Mothupi MC. 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; 2014 issue 14: pg 432.

Banda Y, Chapman V, Goldenberg RL, Stringer JSA, Culhane JF, Sinkala M, Vermund SH and Chi BH. Use of traditional medicine among pregnant women in Lusaka, Zambia. Journal of Alternative and Complementary Medicine; 2007 13 (1): pg 123–8

Mbogo S. Traditional healers ask MPs to pass law to regulate their work. The daily monitor, available at 2015 accessed on 15th July 2019.

Mekuria AB, Erku DA, Gebresillassie BM, Birru BM, Tizazu B and Ahmedin A. Prevalence and associated factors of herbal medicine use during pregnancy. BMC Complementary and alternative medicine 2017 Vol 4: 123-30.

Frawley J, Adams J, Steel A, Broom A, Gallois C and Sibbritt D. Women’s use and self-prescription of herbal medicine during pregnancy; An examination of 1,835 pregnant women; Women’s Health; 2015 Issues 25-4, Pages 396-402.

UBOS, 2018. Agriculture sector gender statistics profile. MoFPPED

Mukhaye, D and Atukunda N. How government insurance will work. The New Vision Online, available at accessed on 4th July 2019.

Nabunya, C 2005. 70-80% Birth deliveries in Uganda conducted by Traditional Birth Attendants. Uganda Radio Network news available at accessed on 4th July 2019.

Turinawe EB, Rwemisisi JT, Musinguzi LK, de Groot M, Muhangi D, de Vries DH, Mafigiri DK, Katamba A, Parker N and Pool R. Traditional birth attendants (TBAs) as potential agents in promoting male involvement in maternity preparedness: insights from a rural community in Uganda. Journal of Reproductive Health 2016

Adatara P, Afaya A, Baku EA, Salia SM and Asempah A. Perspective of Traditional Birth Attendants on Their Experiences and Roles in Maternal Health Care in Rural Areas of Northern Ghana. International Journal of Reproductive Medicine Volume 2018, Article ID 2165627,

Miller T. Establishing partnerships with traditional birth attendants. BMC pregnancy and child birth. 2017 Vol 234: Page 167-69.


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