Drivers of contraceptive use choice in Zambia

Modern approaches of birth control have emerged as broadly accepted family planning methods in replacement of traditional alternatives. However, the effectiveness of modern contraceptives has been challenged by serious side effects, either experienced or expected, with inhibiting consequences on the acceptability and utilisation of family planning service. This paper disentangles the drivers of none-use, traditional and modern contraceptive use in Zambia using the 2018 Zambian Demographic Health Surveys (DHS) data. The Conditional logit choice modelling technique is employed to account not only for the differences in alternative contraceptive options but also the socioeconomic and demographic characteristics of individual woman making the choice. Empirical results indicate that educated, older and poorer women are likely to adopt the traditional contraceptive methods whereas employed women are indifferent between traditional and modern birth control options. Furthermore, Christian women and those from other religions as well as women with no education prefer no birth control method. The study concludes that employment has the potential to serve as an alternative and safer birth control tool in developing countries and namely in Zambia. Therefore, government's effort to expand family planning program should mainly target non-educated women while promoting safer contraceptive methods. This can be achieved through women education and job creation. (Afr J Reprod Health 2022; 26[5]:13- 27).

Potential of Malawi's medicinal plants in Covid-19 disease management: A review

The Coronavirus Disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has triggered an international pandemic that has led to significant public health problems. To date, limited evidence exists to suggest that drugs are effective against the disease. As possible treatments are being investigated, herbal medicines have shown potential for producing novel antiviral agents for the COVID-19 disease. Aim This review explored the potential of Malawi's traditional medicinal plants for the management of COVID-19. Methods:The authors searched on PubMed and Google scholar for medicinal plants that are used in Malawi and published in openly available peer reviewed journals. Plants linked with antiviral treatment, anti-COVID-19 activity or COVID-19 symptoms management were targeted. These included activity against pneumonia, inflammation, cough, difficulty in breathing, pain/aches, fever, diarrhoea, rheumatism, fatigue, asthma, immunocompromised and cardiovascular diseases.Results:11 studies were found with 306 plant species. 127 plant species had at least one COVID-19 related pharmacological activity. Of these plant species, the number of herbal entities used for each indication was: pain/aches (87), fever (2), pneumonia (9), breathing/asthma problems (5), coughing (11), diarrhoea (1), immunosuppression (8), blood issues (10), fatigue (2), heart problems (11), inflammation (8), rheumatism (10) and viral diseases (12). Thirty (30) species were used for more than one disease and Azedarachta indica topped the list (6 of the 13 COVID-19 related diseases). The majority of the species had phytochemicals known to have antiviral activity or mechanisms of actions linked to COVID-19 and consequent diseases' treatment pathways.Conclusion:Medicinal plants are a promising source of compounds that can be used for drug development of COVID-19 related diseases. This review highlights potential targets for the World Health Organization and other research entities to explore in order to assist in controlling the pandemic.

The perspectives of nursing students regarding the incorporation of African traditional indigenous knowledge in the curriculum

Background: South Africa was caught off guard by the student unrest in 2015 and 2016. This unrest was named the #fees must fall campaign. During this campaign, students raised the issue of decolonisation of the curriculum, challenging the higher education fraternity and the academic community. This was based on the fact that the existing curriculum has inadequate content on African traditional indigenous knowledge (ATIK), and continues to use the Western approach to address the needs of a multicultural, multiracial and multi-ethnic societies. Institutions responded by initiating dialogues regarding decolonisation of the curriculum in senates, scholars and between different health professional bodies. Aim: This article aimed to explore and describe the perspectives of nursing students regarding incorporating ATIK into the curriculum. Methods: Using a participatory transformative approach, researchers and participants worked collaboratively to inform social change. Participants comprised nursing students. The academics, traditional health practitioners, indigenous knowledge holders and primary health care nurses formed the panellists. Data were collected through one communal dialogue workshop, which lasted for 8 hours, tea and lunch included. Data were analysed thematically. Results: Students' perspectives emerged strongly as four themes, namely, politics of identity, displacement and distortion, curriculum content and institutional resistance. Students expressed that the current education system results in an identity crisis. The existing curriculum does not adequately convey an understanding of ATIK; it is displaced and distorted. Conclusion: Nursing science has great potential to incorporate the wealth of ATIK into its curriculum. In spite of a vibrant and rich cultural heritage, the ATIK specific to nursing sciences still needs to be incorporated into the existing curriculum in a responsive and relevant manner

Traditional medicinal plants used for the treatment of diabetes in the Sudan : A review

The prevalence of metabolic disorders such as diabetes among population is of increasing concern worldwide. Sudan is a developing country, where several areas frequently depend on folk medicine. Several herbal preparations have been used in folklore practice in Sudan for the management of diabetes with claims asserting their hypoglycemic effect. Basic research relating to these plants are reviewed in this paper with the intention to highlight their therapeutic potential for the treatment of diabetes and promote their regular use in Sudan. Ethnobotanical information was obtained by an assessment of the available literature in electronic data bases with publications describing the medicinal plants used for the treatment of diabetes. In this review paper, different parts of 38 plant species, are described that are used in the Sudanese traditional medicine and belong to 35 genera and 23 families. Thirty three plants have been documented in scientific literature to possess in vivo antidiabetic activity and only one was ineffective in lowering blood glucose level, namely Striga hermonthica. Many of the plants in the study review have been studied in in vitro models (such as α-amylase or α-glucosidase inhibition) in an effort to explain some of their biomedical interaction. The role of isolated bioactive compounds like trigonelline and 3, 5-dicaffeoylquinic acid in diabetes management is also evaluated in the present review. Ten plants original from Sudan have been already used in clinical trials for the treatment of type 2 diabetes. This review provides useful information on the characterization of such herbal medicines that are utilized in the Sudanese traditional medicine for the control of metabolic syndromes such as diabetes

Traditional uvulectomy among the neonates: experience in a Nigerian tertiary health institution

Background: Traditional uvulectomy is widely practiced in some African countries with children more vulnerable to such practices, which may be associated with life threatening complications. Objectives: To determine the age at the time of the procedure, reasons and complication(s) following traditional uvulectomy. Materials And Methods: Retrospective study of hospitalized neonates presenting as emergencies following traditional uvulectomy to the accident and emergency department of the Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria, from June, 2004 to May, 2015. Results: A total of 21 cases were reviewed. Twelve(57.1%) males and 9(42.9%) were females: ratio of 1.3:1. The age ranged from 1 to 21 days with the mean age of 8.8 days. Majority 11(52.4%) of the thtraditional uvulectomies were performed before the 7 day of life. The mean duration before hospitalization was 8.4 hours. Post-uvulectomy haemorrhage 18(85.7%) was the most common complication and this was followed by septicaemia 3 (14.3%) with 2(9.5%) mortalities from the septicaemia. All the patients were anaemic. Prevention of sore throat 12(57.1%) was the main reason for traditional uvulectomy. Sixteen (76.2%) patients were lost to follow-up. Conclusion: Neonatal traditional uvulectomy was mostly done in the first week of life, prevention of sore throat was the common intent and complicated with post-uvulectomy bleeding and septicaemia. Health institutions have a role to play in public health education on the harmful effects of traditional uvulectomy

"I don't know anything about their culture": the disconnect between allopathic and traditional maternity care providers in rural Northern Ghana

The provision of maternal and neonatal health care in rural northern Ghana is pluralistic, consisting of traditional and allopathic providers. Although women often use these providers interchangeably, important differences exist. This study explored the differences in approaches to maternal and neonatal care provision by these two different types of providers. This research was part of the Stillbirth and Neonatal Death Study (SANDS), conducted in northern Ghana in 2010. Trained field staff of the Navrongo Health Research Centre conducted in-depth interviews with 13 allopathic and 8 traditional providers. Interviews were audio-recorded, transcribed, and analyzed using in vivo coding and discussion amongst the research team. Three overarching themes resulted: 1) many allopathic providers were isolated from the culture of the communities in which they practiced, while traditional providers were much more aware of the local cultural beliefs and practices. 2) Allopathic and traditional healthcare providers have different frameworks for understanding health and disease, with allopathic providers relying heavily on their biomedical knowledge, and traditional providers drawing on their knowledge of natural remedies. 3) All providers agreed that education directed at pregnant women, providers (both allopathic and traditional), and the community at large is needed to improve maternal and neonatal outcomes. Our findings suggest that, among other things, programmatic efforts need to be placed on the cultural education of allopathic providers. (Afr J Reprod Health 2014; 18[2]: 36-45)

Traditional practices and medicinal plants use during pregnancy by Anyi-Ndenye Women (Eastern Côte d'Ivoire)

The use of plants during pregnancy is a common practice in Africa. In Côte d'Ivoire, despite modern antenatal medical prescriptions, most pregnant women resort to traditional medicine to ensure foetus development and facilitate childbirth. Yet, there is not enough research on the African traditional medicine concerning this aspect of health. Therefore, the plants used by pregnant women need to be better known in order to offer integrated antenatal care. This study analyzes the salience of plants used, the associated practices and reasons of such practices by pregnant women in Yakassé-Féyassé, an Anyi-Ndenye town of the Eastern Côte d'Ivoire. Methods include an ethnobotany survey (freelist method, interview with pregnant women during their antenatal consultation and with specialists). The survey led to a list of 75 plants distributed in 3 class of salience. In addition, 90.3 % of pregnant women use these practices which are nevertheless ignored by Midwives during antenatal visits (Afr J Reprod Health 2011; 15[1]: 85-93)

L' introduction de plantes medicinales dans le traitement de l'infection a VIH : une approche reussie au Burkina Faso

La recherche et le developpement de medicaments traditionnels anti-VIH/SIDA est un processus complexe qui integre de nombreux defis. Ce processus comprend les evaluations precliniques et cliniques ainsi que la valorisation industrielle; avec la mise sur le marche de medicaments respectant des normes de qualite; d'innocuite et d'efficacite therapeutique. Si de nombreuses plantes africaines ont deja fait l'objet d'evaluations precliniques avec des resultats encourageants; les etudes cliniques comparatives sont encore insuffisantes. L'espoir est cependant permis; comme nous le montre l'experience du Burkina Faso; notamment a travers le developpement de deux medicaments qui ont franchi aujourd'hui avec succes l'etape d'essai clinique Phase II; et surtout l'identification des plantes medicinales pouvant avoir une interference negative avec les traitements antiretroviraux

Promotion de la medecine traditionnelle du Burkina Faso : essai de developpement d'un medicament antidrepanocytaire; le FACA

La recherche et le developpement de medicaments antidrepanocytaires est une priorite en Afrique; ou vivent la grande majorite des personnes souffrant de drepanocytoses. C'est dans ce sens que le FACA a ete developpe au Burkina Faso; a partir de la Medecine Traditionnelle et avec le soutien du bureau regional de l'OMS. Les proprietes antifalciformantes; anti-inflammatoires; antipyretiques et myorelaxantes ont ete evaluees. Il en est de meme de la toxicite. Les plantes composant le FACA; agissent en synergie contre les principaux symptomes de la crise drepanocytaire. Administre en evaluation clinique; le FACA est bien tolere et reduit de maniere significative; la frequence des crises. Apres son autorisation de mise sur le marche; le FACA fait maintenant l'objet d'une production industrielle

Recherche sur la medecine traditionnelle africaine: hypertension

Les institutions de recherche creees pour developper la medecine traditionnelle encouragees dans ce domaine par l'OMS menent des activites vers des maladies prioritaires comme le paludisme; le VIH/SIDA; la drepanocytose; le diabete et l'hypertension arterielle. La prise en charge de l'hypertension arterielle par les medicaments conventionnels est tres elevee amenant plusieurs patients a s'orienter vers la medecine traditionnelle dont les produits ayant l'innocuite; l'efficacite et la qualite prouvees doivent etre utilises. Differents organes des plantes utilisees par les tradipraticiens ont fait l'objet d'etudes phytochimiquediuretique; et antihypertensive au Departement de Medecine Traditionnelle a Bamako et a l'Institut de Recherche en Sciences de la Sante de Ouagadougou: Cymbopogon giganteus; Gynandropsis gynandra; Portulaca oleracea; Jatropha gossypiifolia et une recette de tradipraticien. L'infuse de Portulaca oleracea a la dose de 37;5 mg/kg avec une excretion urinaire de 163;10a donne une importante activite diuretique. Une elevation de la pression arterielle provoquee par l'adrenaline a la dose de 75?g/kg a ete inhibee par le macere aqueux de Jatropha gossipiifolia 94;64a la dose de 20mg/kg. Ces travaux viennent en complement des tests de toxicite pour permettre l'evaluation de l'evidence ethnomedicale sur des recettes a base de ces plantes suivie d'autres tests biologiques de formulation galenique et des essais cliniques. Peu de phytomedicaments de la medecine traditionnelle africaine ont obtenu l'autorisation de mise sur le marche a l'exception du Guinex-HTA produit en Guinee

Natural products research networks in sub-Saharan Africa

Networking is a means of calibrating the quality of work that a group of people is undertaking; fostering international collaboration; pooling of available resources to provide quality training and research in various scientific disciplines and ensuring rapid worldwide dissemination of research information. Several networks involved in research and development of medicinal plants exist in the various sub-regions of the African Region. However; this paper discusses only six such networks of African researchers which share certain common characteristics. These networks aim to foster research on natural products and their sustainable use in human health; and the dissemination of information on research into natural products among others. They also aim to enhance research training capabilities of institutions through national and Regional activities; promote collaboration and research partnerships and mentoring of young researchers in the advancement of natural products research and support the principles of biodiversity conservation. However; these networks have many challenges; mostly financial. A suggestion has been made for the African Network of Drug and Diagnostics Innovation to consider the involvement of other existing networks in its structure for synergizing the efforts to create health products

Explanatory models of mental disorders and treatment practices among traditional healers in Mpumulanga, South Africa

Objective: In many traditional belief systems in Africa; including South Africa; mental health problems may be attributed to the influence of ancestors or to bewitchment. Traditional healers are viewed as having the expertise to address these causes. However; there is limited information on their explanatory models and consequent treatment practices. The present study examines traditional healers' explanatory models (EMs) and treatment practices for psychotic and non-psychotic mental illnesses. Method: 4 focus group discussions (8 healers in each group) and 18 in-depth interviews were conducted. Four vignettes were presented (schizophrenia; depression; panic and somatization) and traditional healers' views on the nature of the problem; cause; consequence; treatment and patient expectations were elicited. Results: Traditional healers held multiple explanatory models for psychotic and non-psychotic disorders. Psychotic illnesses appear to be the main exemplar of mental illness and were treated with traditional medicine; while nonpsychotic illnesses were not viewed as a mental illness at all. Additionally; traditional healers do not only use herbs and substances solely from ""traditional"" sources but rather have incorporated into their treatment practices modern ingredients that are potentially toxic. Conclusion: Interventions aimed at increasing the mental health literacy of traditional healers are essential. In addition; investigations of the effectiveness of traditional healer treatment for psychiatric disorders should be conducted

Patients consulting traditional health practioners in the context of HIV/AIDS in urban areas in Kwazulu-Natal, South Africa

The purpose of this study is to assess patients consulting full-time traditional health practitioners (THPs) and the practice of THPs after they had been trained on Human Immunodeficiency Virus (HIV)/ Sexually Transmitted Infections (STI) prevention and care. The sample included 222 patients interviewed when exiting a THP's practice (n=17) in purposefully chosen two urban sites in KwaZulu-Natal. Results indicate that at post training evaluation the majority of the THPs were involved in HIV/STI management and most had low levels of HIV risk practices at the workplace. Major self-reported reasons for consulting the THP included a complex of supernatural or psychosocial problems; chronic conditions, acute conditions, generalized pain, HIV and other STIs. Overall, patients including HIV positive (n=18) patients had moderate knowledge of Antiretroviral Therapy (ART). A number of HIV positive patients were using traditional medicine and ART concurrently, dropped out of ART because of side effects and were using traditional medicine for HIV

Medicinal plants used in the management of malaria among the traditional medicine practitioners (tmp's) in south western Nigeria

This study examined the type of medicinal plants used in the management of malaria in the Yoruba folklore in south western Nigeria. 87 Traditional medicine practitioners (TMP's) were interviewed. Plants available in the regions were considered in the survey and recorded with their local names; parts used; preparation and the modes of use. A total of 21 plant species used by TMP`s in the management of malaria infections were identified. These species belong to 18 plant families

Contribution a la connaissance des plantes medicinales utilisees dans les soins infantiles en pays San; au Burkina Faso

La presente etude contribue a la connaissance des plantes medicinales et des recettes medicamenteuses utilisees dans les soins infantiles au Pays San; situe au Nord-ouest du Burkina Faso. A la suite d'enquetes ethnobotaniques; 50 tradipraticiens de sante; ayant au moins 15 ans d'experience ont ete interroges. La technique utilisee etait l'entretien semi-directif a partir d'un questionnaire elabore. Au total 79 especes medicinales ont ete recensees; reparties en 69 genres et 34 familles dont les mieux representees sont les Ceasalpiniaceae (7 genres et 9 especes); les Mimosaceae (6 genres et 9 especes); les Combretaceae (4 genres et 8 especes) et les Anacardiaceae (4 genres et 5 especes). Quelques 90de ces especes sont des plantes ligneuses (arbres; arbustes; lianes et sous-arbrisseaux). Isolees ou en association; ces plantes entrent dans la formulation de 167 recettes medicamenteuses; et les feuilles constituent les principaux organes sollicites. La decoction et la boisson sont predominantes pour l'acquisition et l'administration des remedes respectivement. Le paludisme et la diarrhee sont les plus cites sur les 34 maladies infantiles recensees

Complications après usage de produits de la pharmacopée traditionnelle (aspects cliniques)

Les intoxications après usage de préparations de la pharmacopée traditionnelle sont graves. Les auteurs ont identifié 4 tableaux cliniques. Ils déplorent l'importante mortalité et pensent qu'une évaluation rationnelle de ces produits permettrait outre la sécurité de l'usage, le traitement ciblé des intoxications

Neuropaludisme et intoxication de l'enfant zairois a l'ocimum gratissimum linn

Les auteurs rapportent 18 cas de neuropaludisme associe a l'intoxication a l'Ocimum gratissimum Linn; chez les enfants zairois dans le service de pediatrie des Cliniques Universitaires de Kinshasa (Zaire); lors d'une etude retrospective de 24 ans. Ils relevent une hypoglycemie chez 100 pour cent des patients; alors que ceux-ci n'avaient pas ete prealablement soumis a une medication de la pharmacopee occidentale avant l'admission. Ils signalent en outre 38;6 pour cent des deces survenus entre la 24e et la 48e heures d'hospitalisation. La notion de lavement a l'Ocimum gratissimum Linn est confirmee chez tous les patients. Les resultats des etudes experimentales en cours cherchant a demontrer l'effet hypoglycemant de l'Ocimum gratissimum Linn seront publies ulterieurement