Authors: Cecilia Promise Maliwichi-Nyirenda, PhD; Scientific Officer, Lucy Lynn Maliwichi, PhD, National Herbarium and Botanic Gardens of Malawi, Zomba, Malawi, and others)
Abstract: A large proportion of Malawi’s population is poor and unable to meet their basic needs. The country has not experienced a significant economic growth over the years to help eradicate extreme poverty and hunger. Poverty is one of the main contributing factors towards maternal mortality because women cannot afford conventional medical care. Malawi is the 13th poorest country with high maternal mortality rate of 984 maternal deaths per 100,000 live births. Although the government has made investment in health sector, most health facilities, which provide free services, lack essential drugs and equipment. Better services are provided by district and central hospitals but these are few and not readily accessible. People from rural areas are only attended to by district and central hospitals if they have a referral letter from health centres. In addition, private hospitals, which are fully equipped and readily accessible, charge exorbitant fees. This study investigated, through participatory rural appraisal and questionnaire interviews, how maternal problems are managed in rural areas of Mulanje District in Malawi. Thirty three diseases were documented. There were mixed responses towards the causes of maternal mortality. Uterine rupture however seemed to be the major cause of maternal deaths. According to Ministry of Health and Population, uterine ruptures are caused by use of medicinal plants hence bans use of medicinal plants by pregnant women. Despite the ban, the study found that people still use medicinal plants. Trained traditional birth attendants, who are prohibited by the Ministry of Health and Population from using medicinal plants, were also found using medicinal plants. Thirty-two ailments prevalent among pregnant women were documented. Ten medicinal plant species used for six commonly prevalent maternity cases were also documented. Continued use of medicinal plants was attributed to inaccessibility of conventional health facilities, cultural reasons and poor reception at conventional hospitals. Despite being resource-limited, traditional medical practitioners especially traditional birth attendants, undertake substantial amount of child deliveries (at least 1,100 per month). It is anticipated that for as long as the problems facing modern maternal healthcare delivery services prevail, people shall continue to use medicinal plants. There is there fore, a need to investigate if there is any link between medicinal plant use and maternal deaths so as to facilitate the safe consumption of these medicinal plants.