Table 1.
Characteristics of cross-sectional studies evaluating herbal medicine use during pregnancy in sub-Saharan Africa.
| Reference | Study setting | Sample size | Prevalence of use | Types of medicinal plants used | Indications | Characteristics of users | Disclosure of herbal use to health care providers |
|---|---|---|---|---|---|---|---|
| (Banda et al., 2007) | Lusaka, Zambia | 1,128 | 21% | Not reported | Not reported | - Users were not different from non-users in terms of age, education, ethnicity, or income - Users were more likely to drink alcohol during pregnancy, have at least two sex partners, engage in “dry sex”, initiate sex with their partner, report a previously treated sexually transmitted disease, and use contraception (all p < 0.01) |
64% of users did not want to share their use of herbal medicine to health care providers |
| (Maluma et al., 2017) | Lusaka Province, Zambia | 273 | 32% | Indigenous local plants: “Moono”, “Makole”, “Mulolo”, “Sope” | Inducing or accelerating labor | - Herbal medicine use was not associated with residence area, age, or education level - Sociocultural beliefs were the major factors that contributed to use of herbal medicine during pregnancy - Most users were unaware of health risks associated with administering crude herbal extracts during different trimesters of pregnancy |
Not reported |
| (James et al., 2018a) | Freetown, Sierra Leone | 134 | 62.7% | Luffa acutangula (L.) Roxb., lime leaves (Citrus aurantiifolia (Christm.) Swingle), ginger | Urinary tract infections, pedal edema, to improve fetal outcomes | - Pregnant women who identified as Muslims were 3.4 times more likely (p = 0.006) than Christian women to use herbal medicine - Perceived effectiveness and safety of herbal medicines over conventional medicines (70.2%) was the main reason for use |
95.2% of users did not disclose their herbal medicine use to their conventional health care providers |
| (Mureyi et al., 2012) | Harare, Zimbabwe | 248 | 52% | Pouzolzia mixta Sohms, cocktails of unknown herbs, okra (Abelmoschus esculentus (L.) Moench) | For widening of birth canal, labor induction, nutritional supplement | - Herbal medicine use in pregnancy was significantly associated with being in the 20–25 age group (p = 0.021), nulliparity (p = 0.004), nulligravidity (p = 0.002), and residing in a high-density neighborhood (p = 0.04) - Almost all herbal medicine interventions were employed beginning at onset of the third trimester |
Not reported |
| (Mawoza et al., 2019) | Rural Zimbabwe | 398 | 69.9% | Fadogia ancylantha Schweinf., okra (Abelmoschus esculentus (L.) Moench), chir pine (Pinus roxburghii Sarg.) | To facilitate childbirth, for widening of birth canal | No association was noted between herbal medicine use and any sociodemographic characteristic | Not reported |
| (Godlove, 2011) | Mbeya, southwest Tanzania | 400 | 55% | Not reported | Labor induction, to improve fetal outcomes | - The use of herbal medicines during pregnancy was associated with long distance to the nearest public health facility, and low education level (all p ≤ 0.01) - The insufficient effectiveness of conventional medicines (64.1%) and the accessibility of herbal medicines (30.5%) were reported as the main reasons for use |
Not reported |
| (Bayisa et al., 2014) | Nekemte, Western Ethiopia | 250 | 50.4% | Ginger, garlic, Tena Adam (Ruta chalepensis L.), eucalyptus (Eucalyptus globulus Labill.) | For treatment of nausea, morning sickness, vomiting, cough | - Age, educational status, marriage, ethnicity, and source of information were not associated with herbal medicine use - About 70% of users were pregnant women on their first trimester |
Not reported |
| (Laelago et al., 2016) | Hossana, Southern Ethiopia | 363 | 73.1% | Garlic, ginger, Tena Adam (Ruta chalepensis L.), Dama Kesse (Ocimum lamiifolium Hochst. ex Benth.), eucalyptus (Eucalyptus globulus Labill.) | Management of nausea, vomiting, abdominal pain, common cold | Being in the first trimester of pregnancy, having less education, and having less knowledge about herbal medicine favored the use of medicinal plants | Not reported |
| (Mekuria et al., 2017) | Gondar, Northern Ethiopia | 364 | 48.6% | Ginger, Dama Kesse (Ocimum lamiifolium Hochst. ex Benth.) | Common cold, inflammation | - Rural residency, having no formal education, and having an average monthly income <100 United States Dollars were found to be strong predictors of herbal medicine use - 68.4% of users consumed herbal medicines during their third trimester |
89.8% of users had not consulted their doctors about their herbal medicine use |
| (Fakeye et al., 2009) | North Central, North West and South West, Nigeria | 595 | 67.5% | Not reported | Not reported | - Age (p = 0.003), geographical zones (p = 0.02), and educational status (p = 0.04) were significantly associated with herbal medicine use - Users used medicinal plants because they perceived them as being more effective than conventional medicines (22.4%), and safe (21.1%) - 56.6% of participants did not support combining herbal medicines with conventional medications to forestall drug-herb interaction |
Not reported |
| (Tamuno et al., 2010) | Kano, North West Nigeria | 500 | 31.4% | Ginger, garlic | Not reported | - Use of herbal medicine was significantly associated with no formal education and low socioeconomic status (p < 0.05 for both) - Over 40% of women reported combined use of herbs and drugs |
Not reported |
| (Duru et al., 2016) | Owerri, South East Nigeria | 500 | 36.8% | Bitter leaf (Gymnanthemum amygdalinum (Delile) Sch.Bip.), palm kernel oil, bitter kola (Garcinia kola Heckel) | Not reported | Being married (p < 0.001), having no formal education (p < 0.001), and having a monthly income >250 USD (p = 0.003) were significantly associated with herbal medicine use during pregnancy | Not reported |
| (Nergard et al., 2015) | One urban and two rural regions, Mali | 209 | 79.9% | Lippia chevalieri Moldenke, Combretum micranthum G. Don, Parkia biglobosa (Jacq.) R.Br. ex G.Don, Vepris heterophylla (Engl.) Letouzey | For general well-being, to treat malaria symptoms, edema, urinary tract infection, tiredness | - Sociodemographic characteristics were not associated with the use of herbal medicines - Frequent use of herbal medicines was reported during the first semester |
Pregnant women used herbal preparations without any supervision from their health care providers |
| (Mothupi, 2014) | Nairobi, Kenya | 333 | 12% | Not reported | To treat toothache, back pain, flu, indigestion, swollen feet | - The use of herbal medicine was associated with a lower level of education (p = 0.007), and use before the index pregnancy (p < 0.001) - 51% of users reported use of combined herbs with pharmaceutical drugs |
Only 12.5% of users disclosed the use of herbal medicines to health care professionals |
| (Nyeko et al., 2016) | Gulu District, Northern Uganda | 383 | 20.4% | Local herbs (not reported) | To treat abdominal/waist pain, fever, skin problems, nausea and vomiting, and for induction of labor | - Women who used herbal medicines in their previous pregnancies were 8 times more likely to use them during the current pregnancy - Residing more than 5 km from the nearest health facility was associated with increased herbal medicine |
89.7% of the users of herbal medicines did not disclose the use of local herbs to their health care providers |
| (Adusi-Poku et al., 2016) | Offinso North District, Ghana | 384 | 6.5% | Senna occidentalis (L.) Link, Sida acuta Burm.f., Cola gigantea A.Chev. | To ease labor and to improve fetal outcomes | High usage was found among married women, and among those with no formal education, and women with median age of 25 years | Not reported |