CHAPTER ONE
INTRODUCTION
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, 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.
Purpose of the Study
The main objective of
the study is to examine the use of traditional medicine in the treatment
of malaria among pregnant women in Abraka, Delta 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.
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?
Research Hypotheses
The following null hypotheses were formulated in the study:
1. There is no significant difference
between the Socioeconomic status in use of traditional medicine for the
treatment of malaria among pregnant women in Abraka.
2. 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 Abraka.
3. 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 Abraka.
4. 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 Abraka
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
River 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.
Scope/Delimitation of the Study
The study is delimited in
scope to the use of traditional medicine in the treatment of malaria
among pregnant women in Abraka Delta 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.