Plants are commonly used during the antenatal stage in pregnancy to manage different ailments in Africa. In Uganda, both medicinal and food plants are used to handle common pregnancy related conditions. An ethnobotanical survey was conducted in Iganga district, eastern Uganda. Seven traditional birth attendants (TBA) and 46 mothers were interviewed. Data was collected using structured questionnaires and household interviews. The TBAs were identified using snowball sampling. A total of 33 plant species, belonging to 23 families were documented. Out of these, the pregnant mothers used 45.5 % as both food and medicine. The most frequently used plant life form was herbs (58.8%). The leaves are the most commonly used plant parts (59%). Most of the plants (58.8%) were semi cultivated and were being domesticated in crop fields and home gardens. Most of the plants were used to manage anaemia and for child development and good health among the pregnant women. The pregnant women and TBAs in Namungalwe sub County have diverse knowledge on medicinal and nutri-medicinal plants in the management of common pregnancy related diseases, which can be used to supplement modern antenatal services, inspite of the ban of the activities of TBA. Further research on the bioavailability of nutrients, efficacy and safety of the medicinal plants used by pregnant women should be done. (Afr J Reprod Health 2017; 21[4]: 33-44).

Introduction

There is one doctor for every 20,000 people in Uganda and 1.3 midwives and nurses per 1,000 people2 , compared to 200-400 traditional medical practitioners (TMP) for each person . In contrast, the world health organisation recommends a minimum of 23 doctors, nurses and midwives per 10 000 population. In addition, Uganda has a high a maternal mortality rate of 343 per 100,000 live births . In developing countries, up to 80% of the population use traditional medicine to meet their health care needs. In the rural areas of Uganda close to 90% of the population have been reported to rely on traditional medicine to meet their day-to day healthcare needs. Women and children constitute the bulk of the people reliant on herbal medicine. The broad use of traditional medicine is often attributed to its accessibility and affordability. Traditional birth attendants (TBAs) are important community resource persons who are routinely consulted by pregnant women throughout the course of gestation. Although TBAs mainly operate in the rural areas in developing countries10, they also operate in urban areas, and can be an important resource in childbirth care especially among the poor11. They assist many women in developing countries to deliver, although no statistics are currently available on their numbers. In Kenya for example, each female TBA attends to more than two hundred pregnant women during the course of their practice .

A large proportion of children in low and middle-income countries are born outside of conventional health facilities, mainly by unskilled community-based birth attendants13. However, the issue of TBA has generated a lot of debate and controversy. In some countries, their services have been banned, as is the case in Uganda and Malawi. Despite the ban on TBAs in Uganda by the Ministry of Health in 2010, 80% of women in rural areas are still reported to have preference for their services6, 14. Between 58%-80% of pregnant women in western Uganda deliver outside a health facility with the assistance of TBAs.

The TBAs use plant medicines to assist pregnant women to manage diseases10 such as dizziness, nausea and vomiting among others. Medicinal plants play a significant role during pregnancy, birth and postpartum care in many rural areas of the world8,11,17. The use of plants to ensure good development of pregnancy and facilitate labour is a well-established practice in Africa.

Although most natural nutritional supplements used during pregnancy have been replaced with synthetic western drugs, many pregnant women still look to natural herbs to provide essential nutrition and to aid in the relief of some common ailments. The purpose of this study was to document the medicinal plants and practices of TBAs and pregnant women in eastern Uganda in Namungalwe sub-County.