Ethiotime1
Study area and period
The study was conducted at Dessie referral hospital, South Wollo zone in the Amhara region of Ethiopia. Dessie is a town of South Wollo zone located at 401 km from Addis Ababa. The total area of the town is about 15.08 km2 with a population of more than 610,000. In the town, there is one referral hospital which is the biggest service delivering referral hospital to the dweller of the town and surrounding community. The referral hospital has different departments and wards like outpatient department, surgical ward, medical ward and the emergency ward including the emergency service and follow up of chronic diseases like TB, DM and HIV AIDS. It also has antenatal care (ANC) department which provide services that can prevent, detect and treat risk factors early in the pregnancy. Data collection was conducted for one month from May 6 to June 5, 2019 at the ANC department of the hospital.
Study Participants
Study design
A cross sectional survey was carried out among pregnant women on ANC follow-up at DRH using semi-structured questionnaires.
Source and study population of the study: All pregnant women attending DRH were considered as the source population, and all pregnant women on antenatal care follow up at DRH during the data collection period (from May 6 to June 5, 2019) were considered as study population for the study.
Inclusion and Exclusion criteria
The inclusion criterion was being a pregnant woman with age greater than or equal to18 years. Pregnant women who were unable to hear or communicate and mentally disabled women were excluded from the study.
Sample size determination and sampling technique
Prevalence of herbal drug use during pregnancy at Hossana town, 73.1% [15], 95% confidence interval and 5% margin of error were used to calculate the sample size using the single proportion formula. Accordingly, the sample size was calculated to be 302. Since the total number of pregnant women attending ANC department of DRH was 1200, which is less than 10,000, reduction formula was used and the sample size was reduced to 242. Then, 5% contingency was added for possible nonresponse and the final sample size was calculated to be 254 pregnant women. Pregnant women attending the ANC clinic during the one month data collection period were included in the study. Thus, convenience sampling was the sampling technique employed in the study.
Study variables
Herbal medicine use is the dependent variable of this study. Age, Marital status, Number of children, Occupation, Monthly income, residence, Distance from health facilities, Stage of pregnancy and gravida are the independent variables that can possibly affect the dependent variable, herbal medicine use.
Data collection tool and procedure
Data were collected by using semi-structured interviewer administered questionnaire (Additional file 1). The data collection tool (questionnaire) was first prepared in English language based on the aim of the study using a questionnaire of previous similar study as a guide [16]. The questionnaire was then translated to Amharic language. The questionnaire has three sections; section I (Socio-Demographic Information), section II (Obstetrics Information) and section III (Herbal Medicine Use). Pretested data collection questionnaire papers were used for data collection. The aim of the research was mentioned to each study participant and informed consent was received before the data collection. Data were collected by graduating class pharmacy students of Wollo University. The list of local (Amharic) names of medicinal plants or herbs mentioned by the informants was submitted to the Biology department, Wollo University for authentication of the scientific name by the botanist.
Data quality control, processing and analysis
After the questionnaire is prepared, pretest was done for validity and reliability of the questionnaire. Content validity was used to evaluate the validity of the data collection tool. Cronbach’s alpha test was used to measure the reliability, and cronbach’s alpha coefficient was calculated to be >0.70. The data were cleared and checked every day for consistency and completeness.
After completing data collection, the collected data were coded, entered and analyzed using SPSS version 20. Chi squared test and Logistic regression (binary and multivariate) were used to evaluate the association between independent variables (associated factors) and herbal medicine use using COD and AOD at 95% confidence interval, and a P-value <0.05 was considered statistically significant. Variables that showed significant (p<0.05) association with herbal medicine use in the chi squared test were selected for binary logistic regression analysis. Then, variables with P value less than 0.25 in the binary logistic regression analysis were included in the multivariate analysis. Study variables were summarized in tables using frequencies and percentages.
Ethical consideration
Permission to conduct the study in DRH was requested with a formal letter from Wollo University. Ethical approval was received from the ethical review committee of college of medicine and health sciences, Wollo University (reference number, WU/1224/08/11) before data collection. Verbal informed consent was received from each study participant after clarifying the objective of the study. Confidentiality of the information obtained was ensured throughout the study.
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