Complementary and Alternative Medicine Utilization among Pregnant Women Attending Antenatal Care Clinics in Tongaren Sub-County, Kenya: a Cross-sectional Survey

Main Article Content

Ms Martha Makhapila
Dr. George Makalliwa
Dr. Samuel Mong’are


Background: In Kenya, Complementary and Alternative Medicine (CAM) has been used in almost every culture to manage intolerable symptoms of pregnancy since ancient times. However, studies in Kenya have focused on herbal medicine which is just one of CAM practices. In rural settings (such Tongaren Sub-County), no studies have ever evaluated the prevalence and determinants of CAM use during pregnancy including the common CAM modalities used, and so there is need to bridge these knowledge gaps. 

Purpose: This study aimed at determining the prevalence of CAM utilization and associated factors among pregnant women attending antenatal care clinics in Tongaren Sub-County, Bungoma County.

Methods: A cross-sectional descriptive study design was employed in collecting data from 340 pregnant women attending antenatal clinics in Tongaren, Kenya. Quantitative data was collected through semi-structured questionnaires. Chi-square test was used to establish the associations between socio-demographic variables and CAM usage, and multiple logistic regressions were used to examine the relative effects of the various aspects of the variables which were significantly associated with CAM usage.

Results: Among the 340 participants, 50.7% indicated using CAM modalities during pregnancy, indicating that CAM use prevalence in Tongaren is about 50%. 55.80% of CAM users concomitantly use CAM and conventional medicine. The high CAM use prevalence among participants was motivated by the preference of CAM over conventional medicine for certain illnesses (31.4%) and the perceived lack of response to conventional medicine (20.1%). It was noted that marital status, educational attainment of the spouse, employment status, occupation type, and household monthly income level are the major determinants of CAM usage. From the logistic regression analysis, the variables positively associated with CAM use among pregnant women were married status (Odds ratio (OR) = 2.341, p = 0.008), having a spouse with informal education (OR = 5.371, p < 0.001), self-employed status (OR = 0.415, p = 0.028), farming occupation (OR = 2.777, p = 0.206), and household monthly income higher than 35,000 Kshs (OR = 0.093, p = 0.012).

Conclusions: Due to the widespread trust in the safety and efficacy of CAM, the utilization of CAM during pregnancy is common among women in Tongaren Sub-County, which is a rural setting, and therefore CAM can be regarded as the backbone of rural health care in Kenya.

Article Details

How to Cite
MAKHAPILA, M., Makalliwa, G. ., & Mong’are, S. . (2022). Complementary and Alternative Medicine Utilization among Pregnant Women Attending Antenatal Care Clinics in Tongaren Sub-County, Kenya: a Cross-sectional Survey. Women, Midwives and Midwifery, 2(1), 65-83.
Author Biographies

Ms Martha Makhapila, School of Public Health, Jomo Kenyatta University of Agriculture and Technology

School of Health Sciences

Dr. George Makalliwa, School of Public Health, Jomo Kenyatta University of Agriculture and Technology

School of Public Health

Dr. Samuel Mong’are, School of Health Sciences, Kisii University

School of Health Sciences


(KNBS), K. N. B. of S. (2013). Exploring Kenya’s inequality: pulling apart or pooling together (abridged version)?

(KNBS), K. N. B. of S. (2014). Kenya Demographic and Health Survey 2014.

Adams, Easthope, & Sibbritt. (2003). Exploring the relationship between women’s health and the use of complementary and alternative medicine. Complementary Therapies in Medicine, 11(3), 156–158.

Addo. (2007). Herbal medicines: socio-demographic characteristics and pattern of use by patients in a tertiary obstetrics and gynaecology unit. Journal of Science and Technology (Ghana), 27(3), 149–155.

Amasha, & Jarrah. (2012). The use of home remedies by pregnant mothers as a treatment of pregnancy related complaints: An exploratory study. The Medical Journal of Cairo University, 80(2).

Anwar, Green, Norris, & Bukhari. (2015). Self-medication, home remedies, and spiritual healing: common responses to everyday symptoms in Pakistan. Health Psychology and Behavioral Medicine, 3(1), 281–295.

Bercaw, Maheshwari, & Sangi-Haghpeykar. (2010). The use during pregnancy of prescription, over-the-counter, and alternative medications among Hispanic women. Birth, 37(3), 211–218.

Bishop, Northstone, Green, & Thompson. (2011). The use of complementary and alternative medicine in pregnancy: data from the Avon Longitudinal Study of Parents and Children (ALSPAC). Complementary Therapies in Medicine, 19(6), 303–310.

Biswas, A., Dalal, K., Abdullah, A. S. M., Rahman, A. K. M. F., & Halim, A. (2020). Gestational diabetes: Exploring the perceptions, practices and barriers of the community and healthcare providers in rural Bangladesh: A qualitative study. Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy, 13, 1339–1348.

Dal’Belo, Gaspa, R., & Campos, B. M. (2006). The moisturizing effect of cosmetic formulations containing Aloe vera extract in different concentrations assessed by skin bioengineering techniques. Skin Research and Technology, 12(4), 241–246.

Frawley. (2015). Women’s use of complementary and alternative medicine products and services during pregnancy: Insights for safe, informed maternity care (Doctoral dissertation, University of Technology).

Gama – Sitosterol. (2019). National Center for Advancing Translational Sciences (NCATS).

Githinji. (2015). Utilization of Herbal Products and Concomitant Use with Conventional Medicine in Githunguri Division, Kiambu County, Kenya (Master’s thesis, Kenyatta University).

Godlove. (2011). Prevalence of herbal medicine use and associated factors among pregnant women attending antenatal clinic at Mbeya Referral Hospital in 2010 (Doctoral dissertation, Muhimbili University of Health and Allied Sciences).

Gyasi. (2014). Analysis Of Factors Influencing Traditional Medicines Utilization In Ghana: Evidence From Kumasi Metropolis AndSekyere South District (Doctoral dissertation), Kwame Nkrumah University of Science and Technology.

Hall, Griffiths, & McKenna. (2013). Keeping childbearing safe: Midwives’ influence on women’s use of complementary and alternative medicine. International Journal of Nursing Practice, 19(4), 437–443.

Hall, & Jolly. (2014). Women’s use of complementary and alternative medicines during pregnancy: a cross-sectional study. Midwifery, 30(5), 499–505.

Haun. (2017). Let’s learn public health: Epidemiological studies made easier. Retrieved March 24.

Hillary. (2013). Utilization of Herbal Medicine during Pregnancy, Labour and Post-Partum Period Among Women at Embu Provincial General Hospital (Master’s thesis), University of Nairobi).

Holst, Wright, Nordeng, & Haavik. (2009). Use of herbal preparations during pregnancy: focus group discussion among expectant mothers attending a hospital antenatal clinic in Norwich, UK. Complementary Therapies in Clinical Practice, 15(4), 225–229.

Hwang, K.-H., Cho, O.-H., & Yoo, Y.-S. (2016). Symptom clusters of ovarian cancer patients undergoing chemotherapy, and their emotional status and quality of life. European Journal of Oncology Nursing, 21, 215–222.

Hwang, Kim, Ahmed, Choi, Al-Hammadi, & Widad. (2016). Use of complementary and alternative medicine in pregnancy: a cross-sectional survey on Iraqi women. BMC Complementary and Alternative Medicine, 16(1), 191.

James, Bah, Tommy, Wardle, & Steel. (2018). Herbal medicines use during pregnancy in Sierra Leone: an exploratory cross-sectional study. Women and Birth, 31(5), 302–305.

Jaradat, & Adawi. (2013). Use of herbal medicines during pregnancy in a group of Palestinian women. Journal of Ethnopharmacology, 150(1), 79–84.

Kalder, Knoblauch, Hrgovic, & Münstedt. (2011). Use of complementary and alternative medicine during pregnancy and delivery. Archives of Gynecology and Obstetrics, 283(3), 475–482.

Kennedy, Lupattelli, Koren, & Nordeng. (2013). Herbal medicine use in pregnancy: results of a multinational study. BMC Complementary and AlternativeMedicine, 13(1), 355.

Laelago, Yohannes, & Lemango. (2016). Prevalence of herbal medicine use and associated factors among pregnant women attending antenatal care at public health facilities in Hossana Town, Southern Ethiopia: a facility-based cross-sectional study. Archives of Public Health, 74(1), 1–8.

Langlois-Klassen, Kipp, Jhangri, & Rubaale. (2007). Use of traditional herbal medicine by AIDS patients in Kabarole District, western Uganda. The American Journal of Tropical Medicine and Hygiene, 77(4), 757–763.

Mahomoodally. (2013). Traditional medicines in Africa: an appraisal of ten potent African medicinal plants. Evidence-Based Complementary and Alternative Medicine, 3(2), 29–36.

Mbarambara, Songa, Wansubi, Mututa, Minga, & Bisangamo. (2016). Self-medication practice among pregnant women attending antenatal care at health centers in Bukavu, Eastern DR Congo. International Journal of Innovation and Applied Studies, 16(1), 38.

Medicine, N. C. for C. and A. (2013). Complementary, Alternative, or Integrative Health: What’s In a Name?

Mothupi. (2014). Use of herbal medicine during pregnancy among women with access to public healthcare in Nairobi, Kenya: a cross-sectional survey. BMC Complementary and Alternative Medicine, 14(1), 1–8.

Mureyi, Monera, & Maponga. (2012). Prevalence and patterns of prenatal use of traditional medicine among women at selected Harare clinics: a cross-sectional study. BMC Complementary and Alternative Medicine, 12(1), 1–7.

Njoroge, & Kibunga. (2007). Herbal medicine acceptance, sources, and utilization for diarrhoea management in a cosmopolitan urban area (Thika, Kenya). African Journal of Ecology, 45(1), 65–70.

Nordeng, & Havnen. (2004). Use of herbal drugs in pregnancy: a survey among 400 Norwegian women. Pharmacoepidemiology and Drug Safety, 34(6), 371–380.

Nzuki. (2016). Utilization of Herbal Medicine among Children under 5 Years of Age in TharakaNithi County, Kenya (Master’s thesis, Kenyatta University).

Ondicho, Ochora, Matu, & Mutai. (2016). Factors associated with the use of herbal medicine among patients in herbal clinics in Gucha District, Kenya. In Scientific Conference Proceedings.

Owumi. (2012). The Political Economy of Maternal and Child Health in Africa. In Isiugho-Abanihe,U.C., Isamah, A.N., Adesina, J.O., (eds.) Currents and Perspectives in Sociology, Ibadan: Malthouse Press Limited.

Peng, Adams, Sibbritt, & Frawley. (2014). A critical review of complementary and alternative medicine use in menopause: focus on prevalence, motivation, decision-making, and communication. Menopause, 21(5), 536–548.

Pettigrew, King, McGee, & Rudolph. (2004). Complementary therapy use by women’s health clinic clients. Alternative Therapies in Health and Medicine, 10(6), 50.

Sattari, Dilmaghanizadeh, Hamishehkar, & Mashayekhi. (2012). Self-reported use and attitudes regarding herbal medicine safety during pregnancy in Iran. Jundishapur Journal of Natural Pharmaceutical Products, 7(2), 45.

Sibbritt, & Adams. (2010). Back pain amongst 8,910 young Australian women: a longitudinal analysis of the use of conventional providers, complementary and alternative medicine (CAM) practitioners and self-prescribed CAM. Clinical Rheumatology, 9(1), 25–32.

Skouteris, Wertheim, Rallis, Paxton, Kelly, & Milgrom. (2008). Use of complementary and alternative medicines by a sample of Australian women during pregnancy. Australian and New Zealand Journal of Obstetrics and Gynaecology, 48(4), 384–390.

Steel, & Adams. (2012). Developing midwifery and complementary medicine collaboration: The potential of interprofessional education? Complementary Therapies in Clinical Practice, 18(4), 261–264.

Steel, Adams, Sibbritt, Broom, Frawley, & Gallois. (2014). Relationship between complementary and alternative medicine use and incidence of adverse birth outcomes: An examination of a nationally representative sample of 1835Australian women. Midwifery.

Strouss, Mackley, Guillen, Paul, & Locke. (2014). Complementary and Alternative Medicine Use in women during pregnancy: do their healthcare providers know? BMC Complementary and Alternative Medicine, 14(1), 85.

Torri, & Hornosty. (2017). Complementary, Alternative, and Traditional Medicine: Prospects and Challenges for Women’s Reproductive Health. Canadian Scholars’ Press.

WHO. (2020). WHO Director-General’s remaks at the media briefing on 2019-nCoV on 11 February 2020.

World Health Organisation. (2019). World Health Organisation. traditional medicine strategy: 2014- 2023.

World Health Organization. (2008). Traditional Medicine. World Health Organization Fact Sheet No134, December 2008.

Yekta, Zamani, Mehdizade, & Farajzadegan. (2007). The pattern of complementary and alternative medicine use in urban population. Journal of Research in Health Sciences, 7(1), 24–31.

Zakarija-Grkovic, I., & Stewart, F. (2020). Treatments for breast engorgement during lactation. Cochrane Database of Systematic Reviews, 2020(9).