Faculty of Public Policy and Governance, Simon Diedong Dombo University of Business and Integrated Development Studies, Wa, Ghana.
Centre for Health Policy, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
BMC Pregnancy Childbirth. 2022 Jul 27;22(1):600. doi: 10.1186/s12884-022-04934-2.
Over the years, governments and stakeholders have implemented various policies/programmes to improve maternal health outcomes in low-middle-income countries. In Ghana, Community Health Officers were trained as midwives to increase access to skilled maternal healthcare. The government subsequently banned traditional birth attendants from providing direct maternal healthcare in 2000. Despite these, there is an unprecedented utilisation of TBAs' services, including herbal uterotonics. This has attempted to defeat stakeholders' campaigns to improve maternal health outcomes. Thus, we explored and highlighted herbal uterotonic consumption in pregnancy and birth and the implications on maternal and newborn health outcomes in North-Western Ghana.
This was an exploratory qualitative study that investigated traditional birth attendants (n = 17) and healthcare providers' (n = 26) perspectives on the intake of herbal uterotonics in pregnancy and childbirth in rural Ghana, using in-depth interviews. A combination of convenience, purposive and snowball sampling procedures were employed in selecting participants.
Findings were captured in two domains: (1) perceived rationale for herbal uterotonic intake, and (2) potential adverse impacts of herbal uterotonic intake in pregnancy and labour, and nine topics: (i) confidence in unskilled attendance at birth, (ii) cost and a shortage of essential medicines, (iii) herbal uterotonics as a remedy for obstetric problems, (iv) herbal uterotonics facilitate birth, (v) attraction of home birth for cultural reasons, (vi) affordability of herbal uterotonics, (vii) unintended consequences and adverse outcomes, (viii) risks using herbal uterotonics to manage fertility and (ix) risks using herbal uterotonics to facilitate home birth.
The findings have suggested that the intake of non-conventional herbal uterotonic is widespread in the study area, although the constituents of the herb are unknown. However, complex and multiple factors of healthcare cost, desire for homebirth, unawareness of the negative effects of such substances, perceived way of addressing obstetric problems and cultural undertones, among others, accounted for herbal uterotonics consumption. We also encourage research into the constituents of 'mansugo' and the potential benefits and adverse effects. We recommend qualitative studies involving previous users of this herbal uterotonic to inform policy and healthcare provision.
多年来，政府和利益相关者实施了各种政策/方案，以改善中低收入国家的孕产妇健康结果。在加纳，培训社区卫生官员作为助产士，以增加获得熟练产妇保健的机会。政府随后于 2000 年禁止传统助产妇直接提供产妇保健服务。尽管如此，传统助产妇的服务，包括草药催产素，仍在被空前地使用。这试图挫败利益相关者改善孕产妇健康结果的运动。因此，我们在加纳西北部探索并强调了怀孕期间和分娩时使用草药催产素的情况，以及对产妇和新生儿健康结果的影响。
这是一项探索性定性研究，调查了传统助产妇（n=17）和医疗保健提供者（n=26）对加纳农村地区怀孕期间和分娩时摄入草药催产素的看法，使用深入访谈。采用便利、目的和滚雪球抽样程序相结合的方法选择参与者。
研究结果分为两个领域：（1）摄入草药催产素的理由，（2）怀孕期间和分娩时摄入草药催产素的潜在不良影响，共九个主题：（1）对非熟练助产的信心，（2）成本和基本药物短缺，（3）草药催产素作为产科问题的补救措施，（4）草药催产素促进分娩，（5）出于文化原因吸引家庭分娩，（6）草药催产素的可负担性，（7）意外后果和不良后果，（8）使用草药催产素管理生育能力的风险，（9）使用草药催产素促进家庭分娩的风险。
研究结果表明，在研究区域，非传统草药催产素的摄入非常普遍，尽管草药的成分尚不清楚。然而，医疗保健成本、家庭分娩愿望、对这些物质的负面影响的认识不足、处理产科问题的感知方式以及文化背景等复杂而多种因素导致了草药催产素的使用。我们还鼓励对“mansugo”的成分以及潜在的益处和不良影响进行研究。我们建议进行涉及该草药催产素以前使用者的定性研究，以为政策和医疗保健提供信息。
