Catherine Kaluwa Kaingu

Practices of traditional birth attendants in Machakos District, kenya.

ETHNOPHARMACOLOGICAL RELEVANCE The aim of the study was to document TBAs practices as well as the indigenous herbal remedies they use to manage pre, intra and post partum complications in a rural Kenyan community. MATERIALS AND METHODS A cross sectional study was conducted on practicing TBAs and their clients living in the study area. Data was collected using structured questionnaires and interviews. Focused group discussions were held with the TBAs to supplement the interviews and questionnaire survey. RESULTS Two hundred TBAs and 20 clients were interviewed. The majority of the TBAs were females 75% of them having attended to over 200 pregnant women over a period of 5 years and above compared to only 6% of the males. A total of 10 pregnancy related complications and symptoms including threatened abortion, labor complications, post partum hemorrhage and retained after birth were recorded. Fifty five plant species most of them belonging to Euphorbiaceae family were identified for the management of the complications. CONCLUSION Traditional Birth Attendants still have a role to play in assisting pregnant women in rural communities. Their knowledge on herbal medicines is equally important and should be preserved for posterity.

Preliminary investigation of contractile activity of Ricinus communis and Euclea divinorum extracts on isolated rabbit uterine strips.

UNLABELLED Ricinus communis and Euclea divinorum of the family Euphorbiaceae and Ebenaceae, respectively, are traditionally used by Traditional Birth Attendants (TBAs) in Machakos district of Kenya to induce or augment labor, manage protracted labor, post-partum hemorrhage and retained after birth. Ethno-pharmacological relevance of the study will be the provision of scientific evidence and justification for the ethnic use of both plants as oxytocic agents in the initiation of labor, treatment of prolonged labor, post-partum hemorrhage and retained placenta. MATERIALS AND METHODS The plants were harvested in the wild, identified and voucher specimens preserved. The root bark was processed to powder form, from which aqueous and ethanol extracts were obtained. Each of the extracts was separately tested on isolated uterine muscle tissue from non-pregnant and pregnant rabbits. The effect on contraction frequency (number of contractions per second) in the absence or presence of oxytocin was evaluated statistically using ANOVA. P values <0.05 were considered significant. RESULTS AND CONCLUSIONS All uteri exhibited a strong initial contraction following exposure to the aqueous and ethanol root bark extracts of both plants. After recovery, the resumed contraction frequencies varied with the plant extract and exogenous hormone. The results show that the extracts of both plants were able to stimulate uterine tissue contractility directly and to augment the tissues response to oxytocin. The increase in uterine contractions as a percentage relative to negative controls was particularly significant in pregnant rabbit tissues in the presence of oxytocin, where increments of up to 245% were observed. Further pharmacological studies are however required to determine the active principles, possible mechanisms of action, efficacy and safety margins of the plant extracts.