Medicinal plants for treatment of diarrhoeal diseases among under-five children: experience from traditional healers in North-eastern Tanzania.

BACKGROUND: Right through history, humans have relied heavily on plants for sustenance and the healing of different ailments. One of the long-standing traditions that communities have inherited from earlier generations is the use of herbal medicines for the treatment of paediatric ailments, including diarrhoea. This study showcased medicinal plants used by traditional healers for the treatment of diarrhoeal diseases among under-five children in North-eastern Tanzania. METHODS AND DESIGN: A qualitative research approach and a narrative research design were employed. The research was carried out in the districts of Korogwe and Handeni in North-eastern Tanzania, with 52 in-depth interviews performed with participants (traditional healers). Purposive sampling method was used to select participants, and a thematic analysis framework was used to analyze the data. RESULTS: Study results indicate that traditional healers had enormous insights and were well informed about medicinal plants that were perceived to be efficacious in treating diarrhoeal diseases among under-five children. A total of 54 medicinal plants were reported by the participants to be effective in healing diarrhoeal diseases among under-five children. However, out of 54 medicinal plants, 15 were predominantly disclosed by the majority of participants. Those medicinal plants include Psidium guajava, Rhus natalensis, Ozoroa insignis, Tamarindus indica, Ocimum suave, Combretum molle, Zanha africana, Solanum incanum, and Ximenia americana. Other medicinal plants mentioned by most participants include, Ochna holstii, Elaeodendron schlechterianum, Albizia anthelmintica, Commiphora pteleifolia, Salacia stuhlmanniana, and Zenkerella grotei. CONCLUSION: All traditional healers seemed to have a clear understanding regarding the medicinal plants that were used to treat diarrhoeal diseases among under-five children. The participants acknowledged to treating under-five children with diarrhoeal diseases using herbal medications on multiple occasions. The findings of this study should inspire more in-depth botanical research to determine whether the medicinal plants reported in this study have anti-diarrhoeal properties.

Community perceptions on the effectiveness of herbal medicines and factors associated with their use in managing diarrhoea among under-five children in North-eastern Tanzania.

BACKGROUND: The demand for herbal medicines continues to increase globally. However, community perceptions on their effectiveness and factors influencing their use have not been extensively investigated, notably in the Tanga Region, North-eastern Tanzania, where their use in treating various diseases, including paediatric diarrhoea, has flourished. According to studies, Tanga Region has a high prevalence of diarrhoea among under-five children. This study explored community perceptions on the effectiveness of herbal medicines and factors associated with their use in managing diarrhoea among under-five children in North-eastern Tanzania. METHODS: A qualitative approach and a narrative design were employed by the present study since they had the potential to reveal unrecognized or unreported research problems. Focus group discussions and in-depth interviews were used to facilitate data collection from June 2022 to February 2023. The methods were chosen since they are the most common sources of qualitative data in health research. Purposive sampling method was used to select 247 participants, which included 171 caretakers, 52 traditional healers, and 24 paediatric health workers. Interviews were conducted until the saturation point was reached. The purposive technique was considered since it was a method that enabled the researcher to select participants who were knowledgeable about the study topic. Data analysis was performed using thematic analysis. RESULTS: Economic hardship, culture and heritage, superstitious beliefs, failure to recover after receiving hospital medication, easy accessibility of herbal medicines, and long distance to the health facility were the factors perceived to be potentially associated with persistent use of herbal medicines among caretakers. The majority of participants believed that herbal treatments were harmless and effective in treating diarrhoea. CONCLUSION: Superstitious beliefs, culture, and heritage were the primary justifications for using herbal medicines. It is vital for the relevant authority to educate the community on the risk of using unproven herbal medicines in order to diminish the effects that may arise from using uninvestigated herbs. As things stand, the use of herbal medications will continue owing to their relevance to the lives of people in the study setting.

Community perspectives: An exploration of potential barriers to men's involvement in maternity care in a central Tanzanian community.

BACKGROUND: Male involvement in maternal health has been linked to positive health outcomes for women and children, as they control household resources and make significant decisions, which influence maternal health. Despite of the important role they have in maternal health care, their actual involvement remains low. The objective of this study was to explore community perspectives on potential barriers to men's involvement in maternity care in central Tanzania. METHODS: Qualitative research methods were used in data collection. We conducted 32 focus group discussions (16 FGDs with men and 16 FGDs with women) and 34 in-depth interviews with community leaders, village health workers and health care providers. Interview guides were used to guide the focus group discussions and in-depth interviews. The interviews and discussions were audio recorded, transcribed and translated into English and imported into QSR NVivo 9 software for thematic analysis. Three themes emerged from the data; men's maternity care involvement indicators, benefits of men's involvement in maternity health care services and barriers to men's involvement in maternity health care services. RESULTS: Both men and women participants acknowledged the importance of men's involvement in maternity health care services, even though few men actually got involved. Identified benefits of men's involvement in maternity health care services include: Learning any risk factors directly from the health care providers and getting prepared in addressing them; and reinforcing adherence to instruction received from the health care provider as family protectors and guardians. Barriers to men's involvement in maternity health care services are systemic; starting from the family, health care and culture-specific gender norms for maternity related behaviour as well as healthcare facilities structural constrains inhibiting implementation of couple-friendly maternity health care services. CONCLUSIONS: Men's involvement in maternity care is influenced by culture-specific maternity-related gender norms. This situation is compounded by the conditions of deprivation that deny women access to resources with which they could find alternative support during pregnancy. Moreover, structures meant for maternal health care services lack privacy, thus inhibiting male partners' presence in the delivery room. Intervention to increase men's involvement in maternity care should address individual and systemic barriers to men's involvement.

Factors influencing men's involvement in antenatal care services: a cross-sectional study in a low resource setting, Central Tanzania.

BACKGROUND: Men's involvement can impact the delays in the decision to seek health care and in reaching a health facility, which are contributing causes for increased maternal mortality. Despite of the call to involve men in antenatal care, their participation is not well understood. This study aimed to determine the level of men's involvement in antenatal care and the factors influencing their involvement in these services. METHODS: A cross sectional study of 966 randomly selected men aged 18 years or older was conducted in Dodoma Region, from June 2014 to November 2015. Face to face interviews were conducted using a pretested structured questionnaire. The outcome variable was men's involvement and was constructed from four dichotomized items which were scored zero to two for low involvement and three to four for high involvement. A multiple logistic model was used to measure the factors influencing men's involvement in antenatal care services. RESULTS: The level of men's involvement in antenatal care was high (53.9%). Majority 89% of respondents made joint decisions on seeking antenatal care. More than half (63.4%) of respondents accompanied their partners to the antenatal clinic at least once. Less than a quarter (23.5%) of men was able to discuss issues related to pregnancy with their partner's health care providers. About 77.3% of respondents provided physical support to their partners during the antenatal period. Factors influencing men's involvement in antenatal care were occupation (AOR = 0.692, 95% CI = 0.511-0.936), ethnicity (AOR = 1.495, 95% CI = 1.066-2.097), religion (AOR = 1.826, 95% CI = 1.245-2.677), waiting time (AOR = 1.444, 95% CI = 1.094-1.906), information regarding men's involvement in antenatal care (AOR = 3.077, 95% CI = 2.076-4.562) and men's perception about theattitude of health care providers (AOR = 1.548, 95%CI = 1.090-2.199). CONCLUSION: Overall, more than half of respondents reported high involvement in antenatal care services. Access to information on men's involvement, religion, occupation, ethnicity, waiting time and men's perception about the attitude of care providers were significant factors influencing men's involvement in antenatal care services in this study. Health promotion is needed to empower men with essential information for meaningful involvement in antenatal care services.

Women's determinant factors for preferred place of delivery in Dodoma region Tanzania: a cross sectional study.

BACKGROUND: Skilled birth attendance is one of the key factors in improving maternal health but less than 50% of women in sub-Saharan African countries do not have the opportunity to be attended to by skilled personnel during childbirth. The aim of the study was to assess the factors determining women's preference for a place to give birth in Dodoma Region, Tanzania. METHODS: This study employed a cross-sectional survey design using quantitative data collection and analysis methods. Data were collected using structured questionnaire administered to 800 women obtained through multistage random sampling. Multivariable logistic regression model was applied to determine the predictors of place of delivery. RESULTS: More than three quarters 629(78.6%) respondents had their last delivery in the health facilities while 171(21.4%) had their last delivery at home/on the way to hospital. Reasons for delivering at home include: abrupt occurrence of labour pain, long distance to the health facilities, lack of money to pay for transport and unfriendly experience with the health care providers. Simple logistic regression model indicate that mothers' education level, number of children, cost of transport the estimated distance to the nearby health facility and occupation were strong predictors of the preferred place of delivery. However, after controlling the potential confounder, the multivariable logistic regression model demonstrated a significant association between delivery at the health facility and the number of children and transport cost. CONCLUSION: Our findings suggest a need for health care providers to enhance health education to women and their spouses about birth preparedness and the importance of delivering at the health facility. There is also a need for the government to increase the number of health facilities including maternity waiting homes and well trained health workers in both rural and urban areas.