THE USE OF TRADITIONAL MEDICINE IN THE TREATMENT OF MALARIA

AMONG PREGNANT WOMEN

TITLE PAGE

Certification

Dedication

Acknowledgement

Table of Content List of Tables

ABSTRACT

CHAPTER ONE: INTRODUCTION

1.1 Background of the study

1.2 Statement of the problem

1.3 Objective of the study

1.4 Research Questions

1.5 Research Hypothesis

1.6 Significance of the study

1.7 Scope of the study

1.8 Limitation Of The Study

CHAPTER TWO

Review Of Literature

CHAPTER THREE: RESEARCH METHODOLOGY

3.1 Area Of The Study

3.2 Study Designs

3.3 Study Population

3.4 Sample Size Determination

3.5 Sampling Technique

3.6 Study Instruments

3.7 Data Collection Methods

3.8 Method Of Data Analysis

3.9 Validity Of The Study

3.10 Reliability Of The Study

3.11 Ethical consideration

CHAPTER FOUR: DATA PRESENTATION AND ANALYSIS

4.1 Data Presentation

4.2 Answering Research Questions

CHAPTER FIVE: CONCLUSION AND RECOMMENDATION

5.0 Summary

5.1 Conclusion

5.2 Recommendation

References

Appendix
 ABSTRACT

This study was carried out to examine the use of traditional medicine in the treatment of
malaria among pregnant women in Abraka, Delta State. To achieve this 4 research
hypothesis were formulated. The survey design was adopted and the simple random
sampling techniques were employed in this study. The population size comprise of pregnant
women aged 15-45 years attending Antenatal Clinics in five (5) selected Health facilities of
Delta State. 420 respondents were recruited using multistage sampling technique while 300
respondents were validated. Self-constructed and validated questionnaire was used for data
collection. The collected and validated questionnaires were analyzed using frequency tables
and percentage. While the hypothesis were tested using T-test statistical tool SPSS v23. The
result of the findings reveals that; there is a significant difference between the
Socioeconomic status in use of traditional medicine for the treatment of malaria among
pregnant women in Abraka, there is a significant difference between the age groups in the
use of traditional medicine for the treatment of malaria by of pregnant women in Abraka,
there is a significant difference between the levels of Education in the use of traditional
medicine for the treatment of malaria among pregnant women in Abraka. And there is a
significant difference between Urban and Rural areas in the use of traditional medicine for
the treatment of malaria by pregnant women in Abraka.Based on the findings, the researcher
recommended that the Delta State Ministry of Health in collaboration with the Malaria
support program should intensify support for radio jingles on TRADITIONAL
TREATMENT with herbs in all the radio station in the state and the sub-station in the LGAs
and the health workers in the ANCs should have well planned health education schedules for
the year and this should include malaria in pregnancy and traditional treatment. Schedules
should be followed religiously so that the pregnant women are well educated. Emphasis
should be made on consequences of malaria to pregnant women and their unborn baby, to
mention but a few.
 CHAPTER ONE

INTRODUCTION

1.1 BACKGROUND OF 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.

1.2 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.

1.3 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.

1.4 Research Questions

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?

1.5 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

1.6 Significance of 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 traditional treatment 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 traditional treatment 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.

1.7 Scope and delimitation of 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.

1.8 Limitation Of The Study

In the cause of the study the researcher encounters some constrain which limited the scope of

the study;

a) AVAILABILITY OF RESEARCH MATERIAL: The research material available to the

researcher is insufficient, thereby limiting the study.

b) TIME: The time frame allocated to the study does not enhance wider coverage as the

researcher has to combine other academic activities and examinations with the study.

c) FINANCE: The finance available for the research work does not allow for wider coverage

as resources are very limited as the researcher has other academic bills to cover.
 CHAPTER TWO

LITERATURE REVIEW

OVERVIEW OF MALARIA IN PREGNANCY

MALARIA

An infectious disease caused by a parasitic protozoan a blood borne parasite the natural

ecology of malaria involves malaria parasites infecting successively two types of hosts:

humans and female Anopheles mosquitoes. Parasitic infection of red blood cells is caused by

Plasmodium falciparum, Plasmodium vivax, Plasmodium malariae and Plasmodium ovale.

Malaria remains a great human scourge. Pregnant women and children below 5 are among

the most vulnerable groups. Considering the closeness between mother and child, effective

measures put in place to protect the mother from malaria could also protect the child and

hence reduce the morbidity and mortality related to malaria. The World Health Organization

during its Global ministerial conference on malaria in 1992 in Amsterdam, approved a

number of control measures which included early diagnosis and prompt effective treatment,

chemoprophylax is in susceptible groups, reduction of man vector contact, Information

Education and Communication, surveillance and research.

Malaria Transmission

The geographic location of Nigeria makes the climate suitable for malaria transmission

throughout the country. It is estimated that up to 97 percent of the country’s more than 150

million people risk getting the disease. The remaining three percent of the population who

live in the mountains in southern Jos (the Plateau State) at an altitude ranging from 1,200 to

1,400 metres, are at relatively low risk for malaria.

Life cycle of malaria parasites

The malaria parasite life cycle involves two hosts. During a blood meal, a malaria-infected

female Anopheles mosquito inoculates sporozoites into the human host. Sporozoites infect

liver cells and mature into schizonts, which rupture and release merozoites. (Of note, in P.

vivax and P. ovale a dormant stage [hypnozoites] can persist in the liver and cause relapses

by invading the bloodstream weeks, or even years later.) After this initial replication in the

liver (exo- erythrocytic schizogony), the parasites undergo asexual multiplication in the

erythrocytes (erythrocytic schizogony). Merozoites infect red blood cells. The ring stage

trophozoites mature into schizonts, which rupture releasing merozoites. Some parasites

differentiate into sexual erythrocytic stages (gametocytes). Blood stage parasites are

responsible for the clinical manifestations of the disease.

The gametocytes, male (microgametocytes) and female (macrogametocytes), are ingested by

an Anopheles mosquito during a blood meal. The parasites’ multiplication in the mosquito is

known as the sporogonic cycle. While in the mosquito's stomach, the microgametes penetrate

the macrogametes generating zygotes. The zygotes in turn become motile and elongated

(ookinetes) which invade the midgut wall of the mosquito where they develop into oocysts.

The oocysts grow, rupture, and release sporozoites, which make their way to the mosquito's

salivary glands. Inoculation of the sporozoites into a new human host perpetuates the malaria

life cycle.

Epidemiology of Malaria

Malaria is ubiquitous in the tropical regions of the world. It is found in Central America, the

Island of Hispaniola in the Carribbean, the Amazon region of South America, throughout

most of Sub-Saharan Africa, parts of the Arabian peninsula, the near East, and in parts of the
South Pacific. Many of these same regions also share heavy HIV/AIDS and TB burdens.33

Malaria is endemic throughout most of the tropics, approximately 3.4 billion people

worldwide who are exposed annually, 1.2 billion are at high risk; the World Health

Organization (WHO) states that more than 207 million developed symptomatic malaria in

2012.33 Malaria is endemic in more than100 countries on 5 continents. Ninety-nine percent of

these countries had on-going malaria transmission. An estimated 3.3 billion people were at

risk of malaria in 2010. Of this total, 2.1 billion at low risk (1 case per 1000 population) were

living mostly in the WHO African (47%) and South-East Asia Regions (37%). Out of 99

countries with on-going malaria transmission, 43 recorded decreases of > 50% in the number

of malaria cases between 2000 and 2010. Another 8 countries recorded decreases of > 25%.

An estimated 655 000 persons died of malaria in 2010 eighty six percent of the victims were

children under 5 years of age, and 91% of malaria deaths occurred in the WHO African

Region. Approximately 300-500 million cases a year. Six countries - Nigeria, the Democratic

Republic of Congo, Burkina Faso, Mozambique, Cote d'Ivoire and Mali - account for 60%,

or 390,000, of malaria deaths.

Malaria is transmitted throughout Nigeria. Five ecological zones define the intensity and

seasonality of transmission and the mosquito vector species: mangrove swamps; rain forest;

guinea-savannah; sudan-savannah; and sahel-savannah. The duration of the transmission

season decreases from year-round transmission in the south to three months or less in the

north. Malaria

accounts for 60% of outpatient visits and 30% of hospitalizations among children under five

years of age. It is also responsible for an estimated 300,000 deaths in children under five

years of age each year and contributes to an estimated 11% of maternal mortality20
Group susceptible to malaria

All are susceptible to malaria some develop immunity after many exposures, normally after 5

years of age in an areas with high transmission of malaria. The highest risk groups are

Pregnant women and children under 5 yrs old. Pregnancy reduces a woman’s immunity to

malaria. Women can suffer from anaemia and give birth to low birth weight babies, which

can contribute to increased infant mortality. Children under 5 have not developed enough

immunity and are the most likely to suffer from cerebral malaria. Also, foreign visitors are at

high risk since they have had little exposure to the disease.

Consequences of Malaria in Pregnancy

Malaria infection during pregnancy poses substantial risk to the mother, her fetus, and the

neonate. The prevalence of parasitemia appears greatest in the second trimester, and

susceptibility to clinical malaria may persist into the early postpartum period. Due to the

endemicity and high transmission rate of malaria in Nigeria, pregnant women have acquired

immunity being resident in stable malaria area and are susceptible to sub-clinical infections,

which may result in adverse effects to both mother and child. It significantly contributes to

anaemia in pregnancy; increases the occurrence of low birth weights; is associated with pre

term deliveries, still births and perinatal mortality. It has been established that pregnancy

quadruples a woman’s risk of malaria illness and doubles her risk of death. 5 Preventing

severe anaemia caused by malaria will lead to fewer pregnant women requiring blood

transfusion thereby reducing the

risk of transfusion-related infections especially HIV and hepatitis B. The adequate control of

malaria in pregnancy should lead to a better outcome of pregnancy, improve survival of

mothers and reduce perinatal mortality.

Current Practices in Preventing Malaria in Pregnancy in Nigeria

Nigeria is currently implementing prevention of Malaria in Pregnancy intervention as a

component of focused antenatal care services (FANC). Focused Antenatal Care provides the

most practical platform for the delivery of these interventions. The key interventions that can

be provided at the ANC for the prevention of malaria in pregnancy include administration of

Sulphadoxine-pyrimethamine (SP) for traditional medicine (TRADITIONAL

TREATMENT) under direct supervision of skilled service providers, distribution of long

lasting insecticidal nets (LLINs), and appropriate case management through prompt

diagnosis and effective treatment with recommended medicines.

Use of Traditional treatment

World Health Organization (WHO) estimates that about 80% of people living in Africa use

traditional medicines for the management of their prevailing diseases (WHO, 2013; Marshall,

1998). Although recent advances in molecular biology and physiological chemistry have

greatly enhanced the understanding and treatment of diseases, a large segment of the

population still depends on traditional treatment as the preferred form of health care (Iwu &

Gbodossou, 2000; Fratkin, 1996). Studies have shown that this high use of traditional

treatments may be due to accessibility, affordability, availability and acceptability of

traditional traditional treatments by majority of the population in developing countries

(Tamuno, 2011; Akerele, Blass, Singh, Chowdhury, Kulshreshtha, Kamboj, & Bishaw

1993).

Traditional healers such as herbalists, midwives and spiritual healers constitute the main

source of assistance for at least 80-90% of rural population with health problems in
developing countries (WHO, 2002). The herbalists are an important national health care

resource in South Africa and they are potentially valuable partners in the delivery of health

care (Kubukeli, 1999). The use of traditional treatments however, is on the increase even in

developed countries because of the belief that herbal remedies are safe because of their

natural origin and have little or no side effects (Jacobsson, Jönsson, Gerdén, & Hägg,, 2009).

The increasing widespread use of traditional traditional treatment has prompted the World

Health Organization to promotes the use of traditional treatment for health care by;

supporting and integrating traditional treatment into national health systems in combination

with national policy and regulation for products, practices and providers to ensure safety and

quality; ensure the use of safe, effective and quality products and practices, based on

available evidence; acknowledge traditional treatment as part of primary health care, to

increase access to care and preserve knowledge and resources; and ensure patient safety by

upgrading the skills and knowledge of herbalist (Akerele, 1987; WHO, 2005; WHO, 2008).

Traditional medicine is a vital part of health care in Nigeria. Nigeria has a rich and diverse

range of flora that has been used by various ethnic communities for treatment of different

diseases (Kokwaro, 2009; Gachathi, 2007). Indeed, more than 250 plants are used by various

ethnic communities in Nigeria as purgatives, laxatives and emetics to treat a range of

diseases (Maina, Kagira, Achila, Karanja, & Ngotho, 2013). Ethnobotanical surveys in

Nigeria indicate that traditional medicine is widely practiced in the country by the different

communities (Jacob, Farah, & Ekaya, 2004; Kareru et al., 2007; Njoroge & Bussmann,

2007).

In Nigeria, at least 90% of the population has used traditional treatment at least once for

various health conditions (Njoroge & Kibunga, 2007). A survey conducted in Thika district,
Nigeria showed that 97.45% of that population preferred to treat or manage diarrhea

conditions with traditional treatment rather than conventional medicine while 52.5% first

seek treatment for diarrhea from herbalists before going to the hospital (Njoroge & Kibunga,

2007). The Samburu people who inhabit the northern part of Nigeria make use of a wide

range of ethno-medicinal resources comprising of about

120 plant species which are used to treat many diseases including malaria, gonorrhea,

hepatitis and polio (Fratkin, 1996). Similar elaborate and rich pharmacopoeia systems have

also been documented for other Nigerian communities such as the Maasai, Gusii, Luo,

Abaluyia and the Kikuyu people (Gachathi, 2007; Kiringe, 2006; Sindiga, 1995).

The conventional system provides for only 30 per cent of the population, implying that more

than two-thirds of Nigerians depend on traditional medicine for their primary health care

needs (NCAPD, 2008). The importance of traditional treatments in Nigeria is evidenced by

the fact that traditional herbalist far outnumber conventional providers. Given the estimated

40,000 herbalist and assuming a population of 38 million Nigerians, there is a herbalist-

patient ratio of 1 to 950 (Maina et al., 2013).

The dependence on medicinal plants is due to lack of access to modern medical services.

Although the majority of Nigerians (80 per cent) live within 5 kilometers of a health facility,

medical services are not always available. Many facilities lack drugs, basic services and

amenities and the cost of medicine is high. In addition, there are shortages of health

professionals and the ratio of doctors to the population remains low at 15 per 100,000

(NCAPD, 2008).

Conventional Health System in Nigeria

Since Nigeria attained her independence in 1963, there has been massive growth and
development of health care systems at various levels. The increased population and the

demand for health care have outstripped the ability of the government to provide effective

health services (Oyaya and Rifkin, 2003). However the government through the Ministry of

Health (MOH) is committed to ensuring that accessible, affordable and effective health

services which will promote the well-being, improve and sustains the health status of the

Nigerian population is made available (MPHS-GOK, 2008; KSPAS- GOK, 2010)

Disease, ignorance, and illiteracy have been found to be the major obstacles in Nigeria. The

Government of Nigeria (GoK) has supported Ministry of Health (MOH) to combat disease,

but maintaining financial of MOH has undergone a lot of difficulties (KNHA, 2005).

Financing and management of Health services has been a major problem in the MOH.

Maintaining growing population without resources, GoK finds it challenging. Despite the

reforms in the Ministry of Health that were introduced in Nigeria, people still source for

health care services elsewhere (Nyamongo, 2002) and a huge population has been using

traditional treatment (Lambert et al., 2011; Kiringe, 2006).

The poor constitute slightly more than half the population of Nigeria and three- quarters of

the poor live in rural with Gucha district having 74% of its population living below poverty

line of one US dollar per day (Chuma et al., 2009). The inaccessibility of modern medicine

to Nigerian‟s population because of escalating costs has necessitated a search for alternative

ways of managing illnesses (Sindiga, 1995).

In the past, modern science had considered methods of traditional knowledge as primitive

and during the colonial era traditional medical practices were often declared as illegal by the

colonial authorities. Consequently doctors and health personnel have in most cases continued

to shun traditional practitioners despite their contribution to meeting the basic health needs of
the population, especially the rural people in developing countries (WHO, 2005).

Many practitioners of conventional medicine view the increasing recognition of traditional

health systems as a failure by modern medicine to satisfy the health care needs of society

while some even feel threatened by a system that they view as unscientific and beyond

rational categorization (Sofowora, 1996).

Analysis of various national policies related to public health and medicinal plants usage

highlighted some issues for example failure to meet basic health conditions due mainly to the

following factors: inadequate decentralization of health services; isolation of some rural

communities; and persistence of traditional beliefs regarding pathology. This has led to

underutilization of available services in health centers and high cost of services provided by

hospitals in relation to the income of the rural population. In addition to recommending

measures to raise consumer awareness, the guidelines suggest that governments establish

standards of practice, treatment and training for complementary medicine (WHO, 2005).

They also encourage collaborations between conventional and traditional care providers to

improve results and help reform the health sector in developing nations (Akerele, 1992).

Traditional treatment Practice

Human beings have engaged in the development of detailed botanical pharmacopoeia

through trial and error with a view to combat illnesses that were often specific to their

localities. The practice of traditional treatment in Nigeria unlike Asia has largely been

considered primitive by the elite (Kigen, Ronoh, Kipkore, & Rotich, 2013).

The high dependence on traditional treatment in most African populations is partly attributed

to traditional beliefs and lack of reliable modern health care (Sindiga, 1995). The decision to

engage with a particular medical channel is influenced by a variety of socio-economic

variables, sex, age, gender, religion, the type of illness, access to services and perceived

quality of services (Tipping & Segall, 1995).

Traditional treatment is commonly chosen by people to treat common diseases and chronic

diseases. Many Nigerians believe in the potency of traditional treatment, even when they can

access modern medicine (Kigen et al., 2013). In many cases they would choose to combine

both herbal and modern medicine, especially if they are afflicted with chronic ailments such

as HIV/AIDS, hypertension, infertility, cancer and diabetes (Kigen et al., 2013). According

to a study done in Taiwan, it was established that patients used traditional treatment for

muscular and joint problem for lung or respiratory complain while others to promote

wellness and quality of life (Daly, Tai, Deng, & Chien, 2009).

Source of Knowledge on Traditional treatment use

In most Nigerian communities, perhaps due to cultural reasons, the practice was considered a

family affair and the practitioner would prefer to transfer the talent to one close relative

(Kigen et al., 2013). Similarly, the herbalist reported that knowledge about traditional

treatment is passed down from parents, relatives and friends and may not necessarily require

any formal education (Enwere, 2009).

Family expectations of receiving treatment from herbalist are one of the reasons for

continuous dependence on traditional treatment. In addition the influence of relatives, friends

and neighbors on health-care seeking behavior for traditional treatments has been reported

globally in adults and children, 51.4% in the United States (Bennett & Brown, 2000) and

60%-86% in developing countries (Danesi & Adetunji, 1994; Oshikoya et al., 2008; Lanski

et al., 2003). Moreover, studies have shown that media such as newspapers advertisements,

television and radio, play an important role in creating awareness (Bennett & Brown, 2000).
Attitude towards Traditional treatment

Traditional treatment has been used for centuries and it is claimed to have gained acceptance

because of its effectiveness. Studies have shown that the attitudes of patients have a strong

association with the utilization of traditional treatment. A study done in South Africa among

Academic and Administrative University staff indicates that patients‟ have positive attitude

towards traditional treatment, with better clinical care and positive outcome after treatment

using traditional treatment (van Staden & Joubert 2014).

Studies carried out so far indicate that this increase in use of herbal remedies for management

of health conditions could be as a result of people perceiving them as natural and therefore

safe, increase in cost of contemporary medicine and increase in advertisement of herbal

remedies. In a study carried out in Murang'a District, Nigeria among people with diabetes

mellitus showed that there was association between the perceptions people have on herbal

remedies and use of traditional treatment (Mwangi, 2003).

Similarly, in Ethiopia, a study done to evaluate the perception and practices of modern and

traditional health practitioners about traditional medicine indicated that there is a perception

that the conventional health system is inadequate to diagnose and treat certain diseases like

evil eyes, epilepsy and gonorrhea (Gatachew, et al., 2002).

Phyto-medicine products

Over the past decade, interest in drugs derived from plants has greatly increased. It is

estimated that about 25% of all modern medicines are directly or indirectly derived from

plants (Cragg & Newman, 2001). The potential of plants as source of conventional drugs

exists for example reserpine, an alkaloid was the first anti- hypertensive drug that was

isolated from the roots of Rauwolfia serpentine (Apocynaceae) in 1952 (Pandey, Debnath,
Gupta, & Chikara, 2011). Safety and effectiveness of some of the medicinal plants have been

evaluated leading to new antimalarial drugs developed from the discovery and isolation of

artemisinin from Artemisia annua L., a plant used in China for almost 2000 years (WHO,

2008).

It is clear that there is a lot of potential in Nigerian traditional treatment judging from the

published laboratory results from the screening of the plant extracts that have been analyzed

in various institutions. The following Nigerian medicinal plants; Albizia gummifera, Boscia

salicifolia,, Rhus natalensis, Vernonia lasiopus, Rhamnus prinoides, Pentas longiflora and

Ficus sur among others, have shown antiplasmodial activity hence effective in malaria

treatment (Gathirwa et al., 2007; Rukunga et al., 2007; Muthaura et al., 2007; Muregi et al.,

2003). Similarly, the aqueous extract of Carissa edulis, Prunus Africana and Melia

azedarach have demonstrated the potential anti-viral activities at non-cytotoxic

concentrations (Tolo et al., 2008). Other studies have shown that water extracts of

Warburgia ugandensis have antifungal activity against Candida albicans (Olila et al., 2001)

and also antileishmanial activity (Ngure et al., 2009). Similary, pentacyclic triterpenes

isolated from Acacia mellifera have demonstrated antimicrobial activity (Mutai et al., 2009)

among other Nigerian medicinal plants.

However, there is need to document the information from herbalists in order to provide a

database for future research and potential for development of new drugs. Information

obtained from ethno-medicine is now being put on a scientific basis and is therefore

important to investigate the knowledge, attitudes and practice on utilization.

Knowledge on Malaria

A study conducted in Rivers41 found that more than three quarters (76.4%) of the women had
correct knowledge that malaria is caused by exposure to mosquito bites. There were however

some respondents with misconceptions that malaria resulted from working in the sun

(11.5%), eating too much of palm oil (4.7%) and witchcraft (1.5%). Most of the women

(71.4%) equally had knowledge that malaria could cause some harm during pregnancy to the

mother or fetus such as abortion, still births, or low birth weight. 41 Nigerian Malaria indicator

survey (NMIS) found that knowledge of malaria is almost universal. Ninety-four percent of

women have heard of malaria, a statistic that varies little by background characteristics. More

than 90 percent of women in all groups have heard of malaria, except in North Central, where

only 88 percent of women report having heard of malaria. 43 Also in the same study eighty-

two percent of women knew that malaria is caused by mosquitoes, while 27 percent said

malaria is caused by dirty surroundings, and 12 percent said malaria is caused by the

presence of stagnant water. Six percent of women said that eating certain foods caused

malaria, and eight percent of women responded that they did not know what caused malaria.

Traditional treatment of Malaria in Pregnancy

Traditional treatment of malaria during pregnancy is a strategy where all pregnant women are

given a full curative dose of herbal supplements at least twice during pregnancy, regardless

of whether they have malaria. Starting as early as possible in the second trimester, herbal

treatments with herbs remains effective in preventing the adverse consequences of malaria

on maternal and fetal outcomes in areas where a high proportion of Plasmodium falciparum

parasites carry quintuple mutations associated with in vivo therapeutic failure to

Sulphadoxine-pyrimethamine

Knowledge of Traditional medicine of Malaria in Pregnancy (Traditional treatment)

The level of knowledge that the pregnant woman has about Traditional treatment will inform
her on whether to regularly attend the ANC to receive HERBS or not and this will affect the

uptake of traditional treatment. Their best and most lively source of this knowledge is at the

ANC where health workers are supposed to educate them. A study conducted in Uganda

found that nearly all respondents (99.4%) had heard about HERBS prior to the interview.

Regarding knowledge on the role of herbs as used during pregnancy, 57% mentioned

prevention of malaria in mother or unborn baby while 15.4% thought it was used to treat

malaria. About 26% and 0.9% respectively, did not know its indication or cited other reasons

not related to malaria46. It is estimated that in 2007, 25% of pregnant women received at

least 1 dose of traditional treatment. The importance of providing Traditional treatment

under direct observation, as directly observed treatment, was stressed. It was also suggested

that WHO recommendations should state that all possible efforts should be made to avoid

HERBS use as monotherapy for malaria treatment in order to protect its efficacy for

Traditional treatment. In another study,47 it was found that some participants perceived

malaria prevention as a component traditional medicine homes, but most did not. Very few

participants in rural areas referred to receiving anti-malarial drugs, LLINs, or rapid

diagnostic testing of malaria with ANC services. Participants did not appear to clearly

understand the difference between chemoprophylaxis (prevention of malaria through

medication) and the specific treatment they have to take in the event of an episode of malaria.

A study conducted in south west Nigeria48 found that about half [109 (52.2%)] of the

respondents, said they have heard about Traditional treatment. Twenty six of the 109 (23.9%)

who have heard about Traditional treatment were able to give a good definition of traditional

treatment and sixty-three (57.8%) said Traditional treatment can be given to pregnant

women. About two thirds of those that have heard of traditional treatment (73/109; 67.0%)
knew that HERBS is the recommended drug for Traditional treatment. Using the different

brand names of HERBS in the market, 13(17.8%) identified Fansidar®, 18(24.7%)

identified Amalar, 42(57.5%) identified malareich which was the major brand given to them

in the ANC clinic as drug used for Traditional treatment. Forty nine (67.1%) of those who

mentioned herbs knew the correct dose of herbs for Traditional treatment.

A study from Kano46 found that Majority 216 (90.4%) of the respondents said that they have

heard about Traditional treatment. The sources of information on Traditional treatment

included electronic media 193 (89.4%) and health workers during antenatal clinic 16 (7.4%).

All respondents knew the local itsekiri name for malaria and they all knew that it was

transmitted by mosquito bite. On whether there are different types of mosquitoes, only a few

of the women who happened to be teachers or health workers knew that there are different

types of mosquitoes transmitting different diseases. The majority thought that all mosquitoes

transmit malaria. Using a combination of respondents’ knowledge of malaria and traditional

treatment, 75 (31.2%), 137 (57.6%), and 27 (11.2%) of the respondents had good, fair, and

poor knowledge of traditional treatment, respectively.

CHAPTER SUMMARY

In this review the researcher has sampled the opinions and views of several authors and

scholars on malaria, its and its effect, traditional treatment practice and the treatment of

malaria during pregnancy. The works of scholars who conducted empirical studies have been

reviewed also. The chapter has made clear the relevant literature.
 CHAPTER THREE

METHODOLOGY

3.1 Area Of The Study

The study was conducted in Delta State. Delta is one of the 36 States in Nigeria. It was

created in 1991 with Asaba as the state capital. It is located in the South - South geo-political

zone of the country. The State lies between latitude 11 0 and 130 North and longitude 80 and

100 15’ East. It is bounded in the north by Niger Republic, in the east by Ondo State, in the

east by Bayelsa State. The state has a total land area of approximately 22,410 square

kilometres. Its topography is characterized by undulating land, with sand dunes of various

sizes spanning several kilometres in parts of the State.

The health system in Delta State has undergone some reform. The State Ministry of Health

(SMOH) provides oversight function in terms of policy direction, resource mobilization and

regulation of the health sector.

3.2 Study Designs

A description cross-sectional study was conducted among pregnant women in Delta State

3.3 Study Population

The main study population includes pregnant women aged 15-45 years attending Antenatal

Clinics in five (5) selected Health facilities of Delta State at the time of the study.

Inclusion Criteria

Pregnant women who had at least one antenatal clinic visit during or before the date of

interview
Exclusion Criteria

Pregnant women who were severely ill and or HIV positive on cotriomoxazole prophylaxis

were excluded from the study as they may be too sick to respond to some questions and

contraindication of herbs to patient on cotriomoxazole.

3.4 Sample Size Determination

The minimum sample size was calculated using the formula:

n= z 2pq
α

d2

Where

n = minimum sample size,

Z = standard normal deviation at 1.96

p = prevalence of Knowledge Traditional treatment (p=57%) 46

q = (1-p), complimentary probability of p

d = the desired precision of the study, a precision of 5% was tolerated which corresponds to

0.05

n = 1.962 x 0.57 x0.43 / 0.052

n = 376

a non response rate of 10% was added to give 418 (required sample size=N/1-f where f is

10%; 376/1-0.1= 418)

A total 420 questionnaires was administered to enhance representativeness

3.5 Sampling Technique

A multistage sampling technique was used to select the participants. Since the state is divided
into 3 senatorial zones.

Stage 1: Selection of LGA

All the local government area (LGAs) in each of the three senatorial districts (consisting of

25 LGAs) were listed and one LGA from each of the three senatorial zones was selected by

balloting.

Stage 2: Selection of Health Facilities

The list of the health facilities offering antenatal care in the selected LGA was obtained from

Health Management Information System (HMIS) Unit of Ministry of Health. A proportionate

sampling was done to select five health facilities. This was done by stratifying the health

facilities in the selected LGA into two (2) strata. Stratum 1 consists of secondary health

facilities and the tertiary hospital and stratum 2 consist of primary health care clinics and

comprehensives health centres. To enhance representativeness, one health facility was

selected by balloting from stratum 1 and in the stratum 2, four (4) health facilities were

selected by simple random sampling (table of random numbers). A total of five health

facilities were selected.

Stage 3: Selection of the respondent

The selection of pregnant women to participate in the study in each sampled HFs was done

using a systematic sampling technique. Using the estimate of the average clinic attendance of

the preceding month a sampling interval was determined for each HFs and applied

accordingly; balloting was employed to determine the first enrollee. The sample size was

distributed among the traditional medicine homes based on proportionate to size allocation

using the estimate of the average home attendance of the preceding year.

3.6 Study Instruments

A semi-structured interviewer administered questionnaire was used to collect information.

The questionnaire consists of two sections A-B. Section A; is on socio-demographic

information which include age, place of residence, gravidity, parity, number of live birth,

number of weeks of gestation, occupation, ethnic group and religion. While section B

contains the research questions.

3.7 Data Collection Methods

Two methods of data collection which are primary source and secondary source were used to

collect data. The primary sources was the use of questionnaires, while the secondary sources

include textbooks, internet, journals, published and unpublished articles and government

publications.

3.8 Method Of Data Analysis

The responses were analyzed using the frequency tables, which provided answers to the

research questions. The hypothesis test was conducted using the student T-test statistical tool,

SPSS v.23

3.9 Validity Of The Study

Validity referred here is the degree or extent to which an instrument actually measures what

is intended to measure. An instrument is valid to the extent that is tailored to achieve the

research objectives. The researcher constructed the questionnaire for the study and submitted

to the project supervisor who used his intellectual knowledge to critically, analytically and

logically examine the instruments relevance of the contents and statements and then made the

instrument valid for the study.

3.10 Reliability Of The Study

The reliability of the research instrument was determined. The Pearson Correlation
Coefficient was used to determine the reliability of the instrument. A co-efficient value of

0.68 indicated that the research instrument was relatively reliable. According to (Taber,

2017) the range of a reasonable reliability is between 0.67 and 0.87.

3.11 Ethical consideration

The study was approved by the Project Committee of the Department. Informed consent was

obtained from all study participants before they were enrolled in the study. Permission was

sought from the relevant authorities to carry out the study. Date to visit the place of study for

questionnaire distribution was put in place in advance.

 CHAPTER FOUR

DATA PRESENTATION AND ANALYSIS

4. INTRODUCTION

This chapter presents the analysis of data derived through the questionnaire and key

informant interview administered on the respondents in the study area. The analysis and

interpretation were derived from the findings of the study. The data analysis depicts the

simple frequency and percentage of the respondents as well as interpretation of the

information gathered. A total of four hundred and twenty (420) questionnaires were

administered to respondents of which three hundred and fifty (350) were returned while three

hundred (300) were validated. This was due to irregular, incomplete and inappropriate

responses to some questionnaire. For this study a total of 300 was validated for the analysis.

4.2 DATA PRESENTATION

The table below shows the summary of the survey. A sample of 420 was calculated for this

study. A total of 300 responses were received and validated. For this study a total of 300 was

used for the analysis.

Table 4.1: Distribution of Questionnaire

Questionnaire Frequency Percentage

Sample size 420 100

Received 350 80

Validated 300 80

Source: Field Survey, 2021

Table 4.2: Demographic data of respondents

Demographic information Frequency percent

 Age

<20 62 14.8

20-29 175 61.2

30-39 46 20.5

≥ 40 15 3.5

Parity

0 64 15.2

1-4 150 54.5

≥5 86 30.3

Marital Status

Single 0 0.0

Married 293 98.3

Divorced 4 1.0

Widowed 3 0.7

Highest level of education

Tertiary 13 3.1

Secondary 56 13.3

Primary 58 13.8

Quranic 120 45.2

None 53 24.5

Place of residence

Urban 90 26.9

Rural 210 73.1

 Occupation

House wife 211 78.8

Trading 77 18.3

Farming 0 0.0

Civil servants 12 2.9

Ethnicity

Igala 42 10

Itsekiri 219 80.7

Urhobo 27 6.4

Others 12 2.9

Source: Field Survey, 2021

4.2 ANSWERING RESEARCH QUESTIONS

Question 1: What is the difference in socio-economic status on the use of traditional herbs in the

treatment of malaria among pregnant women?

Table 4.3: Respondent on question 1

Options Yes No Total

High 120 180 300
40% 60% 100%
Middle 202 98 300
67.33% 32.67% 100%
Low 300 00 300
100% 100%
Field Survey, 2021

From the responses obtained as expressed in the table above on the difference in socio-economic

status on the use of traditional herbs in the treatment of malaria among pregnant women, 40% of the

respondents said yes to the option “High” while the remaining 60% said no. On the option

“Middle” , 67.33% of the total respondents said yes while the remaining 32.67% said no. All the

respondents said yes to the option low. This implies that there is difference in the social economic
status on the use of traditional herbs in the treatment of malaria among pregnant women.

Question 2: What is the difference in the ages of pregnant women on the use of traditional herbs for

the treatment of malaria?

Table 4.4: Respondent on question 2

Options Yes No Total

15-20 100 200 300
33.33% 66.67% 100%
21-25 152 148 300
50.67% 49.33% 100%
26-30 167 133 300
55.67% 44.33% 100%
31-35 150 150 300
50% 50% 100%
36-40 169 131 300
56.33% 43.67% 100%
41-45 145 155 300
48.33% 51.67% 100%
Field Survey, 2021

From the responses obtained as expressed in the table above on the difference in the ages of pregnant

women on the use of traditional herbs for the treatment of malaria, 33.33% of the respondents said

yes to the age bracket “15-20” while the remaining 66.67% said no. On the age bracket of “21-25” ,

50.67% of the total respondents said yes while the remaining 49.33% said no. 55.67% of the

respondents said yes to the age bracket “26-30” while the remaining 44.33% said no. On the age

bracket of “31-35” , 50% of the total respondents said yes while the remaining 50% said no.

On the age bracket of “36-40” , 56.33% of the total respondents said yes while the remaining 43.67%

said no. 48.33% of the respondents said yes to the age bracket “41-45” while the remaining 51.67%

said no.

Question 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?

Table 4.5: Respondent on question 3

Options Yes No Total

Tertiary 100 200 300
 33.33% 66.67% 100%
Secondary 202 98 300
67.33% 32.67% 100%
Primary 250 50 300
83.33% 16.67% 100%
Field Survey, 2021

From the responses obtained as expressed in the table above on the difference in the level of

educational background of pregnant women in the use of traditional herbs for the treatment

of malaria, 33.33% of the respondents said yes to the option “Tertiary” while the remaining 66.67%

said no. On the option “Secondary” , 67.33% of the total respondents said yes while the remaining

32.67% said no. On the option “Primary” , 83.33% of the total respondents said yes while the

remaining 16.67% said no.

Question 4: What is the difference in the locality of pregnant women in the use of traditional

herbs for the treatment of malaria?

Table 4.6: Respondent on question 4

Options Yes No Total

Urban 98 202 300
32.67% 67.33% 100%
Rural 300 0 300
100% 100%
Field Survey, 2021

From the responses obtained as expressed in the table above on the difference in the locality of

pregnant women in the use of traditional herbs for the treatment of malaria , 32.67% of the

respondents said yes to the option “ Urban” while the remaining 67.33% said no. On the option

“Rural” , all the respondents said yes.

Test Of The Hypothesis

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

Hypothesis One

There is no significant difference between the Socioeconomic status in use of traditional

medicine for the treatment of malaria among pregnant women in Abraka.

Table 4.7: Significant difference between the Socioeconomic status in use of traditional medicine

for the treatment of malaria among pregnant women in Abraka.

T-Test
Group Statistics
Socioeconomic Std. Error
status N Mean Std. Deviation Mean
traditional >= Yes 168 208.4000 46.49821 9.29964
medicine < No 132 236.2800 40.35838 4.66018

Independent Samples Test

Levene's
Test for
Equality of
Variances t-test for Equality of Means
95% Confidence Interval
Sig. (2- Mean Std. Error of the Difference
F Sig. t df tailed) Difference Difference Lower Upper
traditional Equal
variances .555 .458 -2.878 298 .005 -27.88000 9.68683 -47.10319 -8.65681
medicine assumed
Equal
variances
-2.680 36.814 .011 -27.88000 10.40195 -48.95996 -6.80004
not
assumed

From the first table above (Group statistics), we can observe that 168 of the respondents said

yes while 132 said no. The mean showed that there is a mean difference of 27.88 between

Socioeconomic status pf pregnant women in use of traditional medicine for the treatment of
malaria. This difference was further explained by the standard deviation of 6 between the two

groups.

The rule states that if the Sig (2-Tailed) value is greater than .05, conclude that there is no

statistically significant difference between the two conditions, while If the Sig (2-Tailed)

value is less than or equal to .05, conclude that there is a statistically significant difference

between the two conditions.

The results shows that Sig (2-Tailed) value (.011 and .005) is less than .05. hence we

conclude that there is a statistically significant difference between socioeconomic status in

use of traditional medicine for the treatment of malaria among pregnant women in Abraka.

Hypothesis Two

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.

Table 4.8: Significant differences the age groups in the use of traditional medicine for the

treatment of malaria by of pregnant women in Abraka.

T-Test
Group Statistics
Std. Error
Age Groups N Mean Std. Deviation Mean
Traditional >= Yes 145 211.5000 52.39821 9.39863
Medicine < No 155 241.3600 44.43837 3.56118

Independent Samples Test

Levene's Test
for Equality of
Variances t-test for Equality of Means
95% Confidence Interval
Sig. (2- Mean Std. Error of the Difference
F Sig. t df tailed) Difference Difference Lower Upper
Traditional Equal
Medicine variances .555 .458 -2.777 298 .005 -26.87000 9.78684 -46.20418 -7.65681
assumed
Equal
variances not -2.511 35.711 .010 -26.87000 10.50196 -47.85985 -5.80004
assumed
From the first table above (Group statistics), we can observe that 145 said yes while 155 said

no. The mean showed that there is a mean difference of 29.86 between the age groups in the

use of traditional medicine for the treatment of malaria by of pregnant women. This

difference was further explained by the standard deviation of 10 between the two groups.

The rule states that if the Sig (2-Tailed) value is greater than .05, conclude that there is no

statistically significant difference between the two conditions, while If the Sig (2-Tailed)

value is less than or equal to .05, conclude that there is a statistically significant difference

between the two conditions.

The results shows that Sig (2-Tailed) value (.010 and .005) is less than .05. hence we

conclude that there is a statistically significant difference the age groups in the use of

traditional medicine for the treatment of malaria by of pregnant women in Abraka.

Hypothesis Three

Table 4.9: Significant differences in the level of educational background of pregnant

women in the use of traditional herbs for the treatment of malaria.

T-Test
Group Statistics
educational Std. Error
background N Mean Std. Deviation Mean
traditional >= Yes 180 228.4201 55.29826 8.38853
herbs < No 120 214.6201 42.53842 4.59128

Independent Samples Test

Levene's
Test for
Equality of
Variances t-test for Equality of Means
95% Confidence Interval
Sig. (2- Mean Std. Error of the Difference
F Sig. t df tailed) Difference Difference Lower Upper
traditional Equal
variances .555 .458 -2.963 298 .005 -25.79000 7.78674 -42.23417 -8.55683
herbs assumed
Equal
variances
-2.708 38.831 .013 -25.79000 9.50199 -43.75787 -3.80305
not
assumed
From the first table above (Group statistics), we can observe that 180 of the respondents said

yes while 120 of the respondents said no. The mean showed that there is a mean difference of

13.8 between the level of educational background of pregnant women in the use of traditional

herbs for the treatment of malaria. This difference was further explained by the standard

deviation of 10 between the two groups.

The rule states that if the Sig (2-Tailed) value is greater than .05, conclude that there is no

statistically significant difference between the two conditions, while If the Sig (2-Tailed)

value is less than or equal to .05, conclude that there is a statistically significant difference

between the two conditions.

The results shows that Sig (2-Tailed) value (.013 and .005) is less than .05. hence we

conclude that there is a statistically significant difference in the level of educational

background of pregnant women in the use of traditional herbs for the treatment of malaria.

Hypothesis Four

Table 4.10: Significant differences in the locality of pregnant women in the use of

traditional herbs for the treatment of malaria.

T-Test
Group Statistics
Std. Error
locality N Mean Std. Deviation Mean
Traditional >= Yes 162 239.9606 61.38727 11.46252
Herbs < No 138 219.8606 47.62846 7.65226

Independent Samples Test

Levene's Test
for Equality of
Variances t-test for Equality of Means
95% Confidence Interval
Sig. (2- Mean Std. Error of the Difference
F Sig. t df tailed) Difference Difference Lower Upper
Traditional Equal
variances .555 .458 -2.671 298 .005 -27.79000 4.78674 -38.23426 -9.55680
Herbs assumed
Equal
variances -2.821 37.812 .012 -27.79000 7.50199 -41.75779 -4.80300
not assumed

From the first table above (Group statistics), we can observe that 162 of the respondents said

yes while 138 of the respondents said no. The mean showed that there is a mean difference of

20.1 between the locality of pregnant women in the use of traditional herbs for the treatment

of malaria. This difference was further explained by the standard deviation of 13.7 between

the two groups.

The rule states that if the Sig (2-Tailed) value is greater than .05, conclude that there is no

statistically significant difference between the two conditions, while If the Sig (2-Tailed)

value is less than or equal to .05, conclude that there is a statistically significant difference

between the two conditions.

The results shows that Sig (2-Tailed) value (.012 and .005) is less than .05. hence we

conclude that there is a statistically significant difference in the locality of pregnant women

in the use of traditional herbs for the treatment of malaria.

 CHAPTER FIVE

SUMMARY, CONCLUSIONS AND RECOMMENDATIONS

5.1 Introduction

This chapter summarizes the findings into the use of traditional medicine in the treatment of

malaria among pregnant women in Abraka, Delta State. The chapter consists of summary of

the study, conclusions, and recommendations.

5.2 Summary of the Study

In this study, our focus was to examine the use of traditional medicine in the treatment of

malaria among pregnant women in Abraka, Delta State. The study specifically was aimed at

determining the influence of socio-economic status on the use of traditional herbs in the

treatment of malaria among pregnant women, finding out the extent to which the age of

pregnant women determine the use of traditional herbs for the treatment of malaria, the

extent to which the level of education of pregnant women determine the use of traditional

herbs for the treatment of malaria, and examining the extent to which the locality of pregnant

women determine the use of locally made herbs for treatment of malaria.

The study adopted the survey research design and randomly enrolled participants in the

study. A total of 300 responses were validated from the enrolled participants where all

respondent are pregnant women aged 15-45 years attending Antenatal Clinics in five (5)

selected Health facilities of Delta State.

5.3 Conclusions

Based on the findings of this study, the researcher made the following conclusion.

1. There is a significant difference between the Socioeconomic status in use of traditional

medicine for the treatment of malaria among pregnant women in Abraka.

2. There is a 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 a 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 a significant difference between Urban and Rural areas in the use of traditional

medicine for the treatment of malaria by pregnant women in Abraka

5.4 Recommendation

Based on the findings of this study, the researcher recommends that the Delta State Ministry

of Health in collaboration with the Malaria support program in the state should:

1. Ensure adequate and regular supplies of herbs to the health facilities.

2. Provide technical support to health facilities on Traditional treatment implementation

through training and re-training of staff in the health facilities.

3. The Delta State Ministry of Health in collaboration with the Malaria support program

should intensify support for radio jingles on TRADITIONAL TREATMENT with herbs in

all the radio station in the state and the sub-station in the LGAs.

4. The health workers in the ANCs should have well planned health education schedules for

the year and this should include malaria in pregnancy and traditional treatment. Schedules

should be followed religiously so that the pregnant women are well educated. Emphasis

should be made on consequences of malaria to pregnant women and their unborn baby.

5. The health workers in the ANCs should be encouraged to ensure detailed documentation

of service delivery at ANC.

5.5 Suggestion for Further Studies

A further research to assess health care provider’s knowledge and training on traditional
treatment implementation including attitude of staff should be conducted by Delta State

Ministry of Health and partners in order bring out more information concerning traditional

treatment implementation.
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APPENDIXE

QUESTIONNAIRE

PLEASE TICK [√] YOUR MOST PREFERRED CHOICE(S) ON A QUESTION.

SECTION A

PERSONAL INFORMATION

Age

<20 [ ]

20-29 [ ]

30-39 [ ]

≥ 40 [ ]

Parity

0 [ ]

1-4 [ ]

≥5 [ ]

Marital Status

Single [ ]

Married [ ]

Divorced [ ]

Widowed [ ]

Highest level of education

Tertiary [ ]

Secondary [ ]

Primary [ ]
Quranic [ ]

None [ ]

Place of residence

Urban [ ]

Rural [ ]

Occupation

House wife [ ]

Trading [ ]

Farming [ ]

Civil servants[ ]

Ethnicity

Igala [ ]

Itsekiri [ ]

Urhobo [ ]

Others [ ]

SECTION B

Question 1: What is the difference in socio-economic status on the use of traditional herbs in the

treatment of malaria among pregnant women?

Options Yes No
High
Middle
Low

Question 2: What is the difference in the ages of pregnant women on the use of traditional herbs for

the treatment of malaria?

Options Yes No
 15-20
21-25
26-30
31-35
36-40
41-45

Question 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?

Options Yes No
Tertiary
Secondary
Primary

Question 4: What is the difference in the locality of pregnant women in the use of traditional

herbs for the treatment of malaria?

Options Yes No
Urban
Rural