Abstract:
Despite CAM being a primary form of healthcare for a large portion of Kenya's population, its utilization during pregnancy remains poorly studied. Limited data is available on the extent to which pregnant women in Kenya’s rural use CAM, and the factors associated with that usage. Therefore to bridge this knowledge gap, this study sought to determine CAM utilization among pregnant women attending antenatal care clinics (ANCs) in Tongaren Sub-County, Bungoma County. Specifically, the study sought to determine the prevalence and patterns of utilization of CAM among pregnant women; evaluated the factors that influence the utilization of CAM therapies; identified the common forms of CAM therapies used; and assessed the rates of CAM use disclosure to healthcare givers and its associated determinants. A cross-sectional survey design was employed in collecting data from 340 systematically sampled pregnant women attending 12 ANCs in Tongaren Sub-County. 340 semi-structured questionnaires and 6 structured interview guides were used to collect the primary data required for the study. Using Statistical Package for the Social Sciences (SPSS), quantitative data was analyzed through descriptive statistics, inferential statistics (Chi-square test of independence to compare associations between nominal variables), and multiple logistic regression analysis to check for the joint influence of multiple independent variables. Findings indicated that 172 out of 340 (50.7%) surveyed pregnant women use CAM during pregnancy, of which half of them concomitantly use CAM and modern medicine while another half use CAM separately. The high prevalence (50.7%) of CAM utilization among the survey participants was majorly motivated by: the preference of CAM over conventional medicine for certain illnesses (31.4%), and the perceived lack of response to conventional medicine (27.1%). Herbal therapies (65.1%) and spiritual remedies (40.1%) were the major forms of CAM utilized to primarily treat some pregnancy-related discomforts (36.2%). About 38 plant species (including Neem tree and Aloe vera) and 4 forms of animal-based therapies (e.g. oils) used during pregnancy were profiled. Prayers were the most frequently used form of spiritual remedies whereas massages were the most commonly used form of alternative/psycho-physical therapies. Herbal and animal-based therapies were ingested or applied on the body, weekly/daily during 1stand 2ndtrimesters of pregnancy. From logistic regression analysis, the variables positively associated with CAM use among pregnant women were marital status (Odds ratio (OR) = 2.341, p = 0.008), having a spouse with no formal education (OR = 5.371, p < 0.001), self-employed status (OR = 0.415, p = 0.028), farming occupation (OR = 2.777, p = 0.026), and monthly income higher than Kshs 35,000 (OR = 0.093, p = 0.012). Over 80% of the 172 CAM users didn’t disclose it to their healthcare givers at the clinics, because of three main reasons, namely, unwillingness to disclose CAM use to anyone, healthcare providers not asking, and fear of the healthcare providers’ reactions. Educational status (χ2 = 11.855, p = 0.037), religion (χ2 = 8.563, p = 0.003), employment status (χ2 = 6.522, p = 0.038), occupation type (χ2 = 10.855, p = 0.013), and insurance status (χ2 = 3.852, p = 0.05) were found to be significantly associated with CAM use disclosure. In conclusion, there is a high prevalence of CAM usage among pregnant women in Tongaren, with many using various CAM therapies (especially herbal forms) alongside conventional medicine, often without disclosing this to healthcare providers. The study recommends, among other measures, the scientific validation of the identified herbal forms and the implementation of targeted CAM awareness campaigns to promote safe and effective CAM use during pregnancy.
