Traditional medicine used in childbirth and for childhood diarrhoea in Nigeria's Cross River State: interviews with traditional practitioners and a statewide cross-sectional study

Abstract

ObjectivesExamine factors associated with use of traditional medicine during childbirth and in management of childhood diarrhoea.DesignCross-sectional cluster survey, household interviews in a stratified last stage random sample of 90 census enumeration areas; unstructured interviews with traditional doctors.SettingOil-rich Cross River State in south-eastern Nigeria has 3.5 million residents, most of whom depend on a subsistence agriculture economy.Participants8089 women aged 15–49 years in 7685 households reported on the health of 11 305 children aged 0–36 months in July–August 2011.Primary and secondary outcome measuresTraditional medicine used at childbirth and for management of childhood diarrhoea; covariates included access to Western medicine and education, economic conditions, engagement with the modern state and family relations. Cluster-adjusted analysis relied on the Mantel-Haenszel procedure and Mantel extension.Results24.1% (1371/5686) of women reported using traditional medicine at childbirth; these women had less education, accessed antenatal care less, experienced more family violence and were less likely to have birth certificates for their children. 11.3% (615/5425) of young children with diarrhoea were taken to traditional medical practitioners; these children were less likely to receive BCG, to have birth certificates, to live in households with a more educated head, or to use fuel other than charcoal for cooking. Education showed a gradient with decreasing use of traditional medicine for childbirth (χ2 135.2) and for childhood diarrhoea (χ2 77.2).ConclusionsUse of traditional medicine is associated with several factors related to cultural transition and to health status, with formal education playing a prominent role. Any assessment of the effectiveness of traditional medicine should anticipate confounding by these factors, which are widely recognised to affect health in their own right.

Use of traditional and complementary medicine for maternal health and wellbeing by African migrant women in Australia: a mixed method study

“…Our analysis found that lower educational level was significantly correlated with increased traditional and complementary medicine use for maternal health and wellbeing. Similar to this finding, other studies have also reported that African women who use traditional medicine were more likely to be less educated [45,46]. Increased use of traditional medicine among the less educated group in this study could be partly explained by the fact that lower education may limit African women's knowledge about available healthcare options in Australia.…”

Traditional, complementary and alternative medicine use in Sub-Saharan Africa: a systematic review

“…Eighteen studies reported the prevalence rates of TCAM use during pregnancy, 24 82-95 childbirth [94][95][96] and for pregnancy termination. 97 Between 12% and 90.3% (mean, 48.4%) of pregnant women were reported to use a TCAM product during pregnancy, a rate consistent across studies drawn from large sample sizes 84 85 93-95 (25.5%-67.5% (average, 45.3%)) and from small sample sizes 24 83 86-92 (12%-90.3% (average, 50.1%)).…”

Indigenous factors relevant for Safe Birth in Cultural Safety among Nancue ñomndaa communities in Guerrero, Mexico

“…(Shenton, 2004): we have adopted a method clearly defined in a protocol with predefined rules for decision making. This methodology has been successfully applied in other studies (Hovey et al, 2017;Sarmiento, Zuluaga, & Andersson, 2016). Traditional midwives are committed to the process of intercultural dialogue and open to share their knowledge.…”