Background of the Study
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 orthodox ones (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 use of traditional medicine in the treatment of malaria among pregnant women in Abraka, Delta State, Nigeria.
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.