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An exploration of village-level uterotonic practices in Fenerive-Est, Madagascar
BACKGROUND: Pharmaceutical uterotonics are effective for preventing postpartum hemorrhage and complications related to unsafe abortion. In Madagascar, however, traditional birth attendants (Matrones) commonly administer medicinal teas for uterotonic purposes. Little is known about Matrone practices...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2016
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4818420/ https://www.ncbi.nlm.nih.gov/pubmed/27036886 http://dx.doi.org/10.1186/s12884-016-0858-3 |
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author | Collins, Lillian Mmari, Kristin Mullany, Luke C. Gruber, Christian W. Favero, Rachel |
author_facet | Collins, Lillian Mmari, Kristin Mullany, Luke C. Gruber, Christian W. Favero, Rachel |
author_sort | Collins, Lillian |
collection | PubMed |
description | BACKGROUND: Pharmaceutical uterotonics are effective for preventing postpartum hemorrhage and complications related to unsafe abortion. In Madagascar, however, traditional birth attendants (Matrones) commonly administer medicinal teas for uterotonic purposes. Little is known about Matrone practices and how they might coincide with efforts to increase uterotonic coverage. The aims of this study were to: 1) identify indications for presumed uterotonic plant use by Matrones, 2) explore uterotonic practices at the village level, and 3) describe the response of health practitioners to village-level uterotonic practices. METHODS: Twelve in-depth interviews with health practitioners, Matrones and community agents were conducted in local dialect. All interviews were audio-recorded, transcribed, and translated into English for analysis using Atlas.ti. Medicinal plant specimens were also collected and analyzed for the presence of uterotonic peptides. RESULTS: While Matrones reported to offer specific teas for uterotonic purposes, health practitioners discussed providing emergency care for women with complications associated with use of specific teas. Complications included retained placenta, hypertonic uterus, hemorrhage and sepsis. Chemical analysis indicated the presence of cysteine-rich peptides in the Dantoroa/Denturus plant used in some Matrones’ teas. CONCLUSIONS: The presence of uterotonic peptides in one plant used by Matrones may indicate that Matrones intend to administer uterotonics for safer childbirth. This finding, combined with practitioner reports of complications related to some medicinal teas, points to a need for availability of an evidence-based uterotonic at the village level, namely, misoprostol pills or oxytocin in the form of uniject. |
format | Online Article Text |
id | pubmed-4818420 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-48184202016-04-03 An exploration of village-level uterotonic practices in Fenerive-Est, Madagascar Collins, Lillian Mmari, Kristin Mullany, Luke C. Gruber, Christian W. Favero, Rachel BMC Pregnancy Childbirth Research Article BACKGROUND: Pharmaceutical uterotonics are effective for preventing postpartum hemorrhage and complications related to unsafe abortion. In Madagascar, however, traditional birth attendants (Matrones) commonly administer medicinal teas for uterotonic purposes. Little is known about Matrone practices and how they might coincide with efforts to increase uterotonic coverage. The aims of this study were to: 1) identify indications for presumed uterotonic plant use by Matrones, 2) explore uterotonic practices at the village level, and 3) describe the response of health practitioners to village-level uterotonic practices. METHODS: Twelve in-depth interviews with health practitioners, Matrones and community agents were conducted in local dialect. All interviews were audio-recorded, transcribed, and translated into English for analysis using Atlas.ti. Medicinal plant specimens were also collected and analyzed for the presence of uterotonic peptides. RESULTS: While Matrones reported to offer specific teas for uterotonic purposes, health practitioners discussed providing emergency care for women with complications associated with use of specific teas. Complications included retained placenta, hypertonic uterus, hemorrhage and sepsis. Chemical analysis indicated the presence of cysteine-rich peptides in the Dantoroa/Denturus plant used in some Matrones’ teas. CONCLUSIONS: The presence of uterotonic peptides in one plant used by Matrones may indicate that Matrones intend to administer uterotonics for safer childbirth. This finding, combined with practitioner reports of complications related to some medicinal teas, points to a need for availability of an evidence-based uterotonic at the village level, namely, misoprostol pills or oxytocin in the form of uniject. BioMed Central 2016-04-01 /pmc/articles/PMC4818420/ /pubmed/27036886 http://dx.doi.org/10.1186/s12884-016-0858-3 Text en © Collins et al. 2016 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Article Collins, Lillian Mmari, Kristin Mullany, Luke C. Gruber, Christian W. Favero, Rachel An exploration of village-level uterotonic practices in Fenerive-Est, Madagascar |
title | An exploration of village-level uterotonic practices in Fenerive-Est, Madagascar |
title_full | An exploration of village-level uterotonic practices in Fenerive-Est, Madagascar |
title_fullStr | An exploration of village-level uterotonic practices in Fenerive-Est, Madagascar |
title_full_unstemmed | An exploration of village-level uterotonic practices in Fenerive-Est, Madagascar |
title_short | An exploration of village-level uterotonic practices in Fenerive-Est, Madagascar |
title_sort | exploration of village-level uterotonic practices in fenerive-est, madagascar |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4818420/ https://www.ncbi.nlm.nih.gov/pubmed/27036886 http://dx.doi.org/10.1186/s12884-016-0858-3 |
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