Journal of Traditional Medicine & Clinical Naturopathy
Open Access

Based on WHO traditional medicine is defined as the sum total of all knowledge and practices, whether explicable or not, used in diagnosis, prevention and elimination of physical, mental, or social imbalance and relying exclusively on practical experience and observation handed down from generation to generation, whether verbally or in writing. The emphasis on the use of medicinal plants had been focus on the treatment rather than prevention of diseases [1].

Maternal and child morbidity and mortality is highest in sub Saharan Africa including Ethiopia due to shortfalls in modern hospitals, women improperly use of medicinal plants About (80%) of the Ethiopia people and (90%) of livestock depend on traditional medicine for their health care and more than 90 and of traditional medicine preparations are made from plant origin. Similarly, there has been a continuous growth of demand for traditional medicines globally and in many developing countries health care system [2].

But when we use in scientific way, traditional medicine continues to play an important role in improving and maintaining health in developing countries. High income and knowledge of medicinal plants are important determinants of use of traditional medicine. This challenges the common assumption that poor and marginalized people are most dependent on traditional medicine due to its availability [3].

Ethiopia is believed to be home for about 6,500 species of higher plants of which 12% are endemic [4] making the country among the most diverse floristic regions of the world [5]. However, conservation of these plants and knowledge of their use have generally been neglected since it was considered irrelevant in earlier times [6]. Moreover, the attitude of the society towards the traditional medicine healers was negative and this forced healers to keep the knowledge secret [7].

But currently different studies have been conducted on Ethnobotany of medicinal plants used to treat various human diseases in different parts of Ethiopia; Traditional medicine is commonly assumed to be a crucial health care option for poor households in the country. However, there has not been any review done that comprehensively expresses the Ethno-botany of plants used to treat maternal and child health illnesses. Therefore, there is a need to assess the overall traditional preparation techniques and types of plants used in the country scientifically. So this review was aimed to provide an overview of Ethno-botany of medicinal plants used to treat maternal and childhood illnesses among the diversified population in Ethiopia. It gives a comprehensive information on the scientific name of plants, method of preparation, route of administration, plant part used and the habit of the plant used and the study will be an input for further study/ call attention of other investigators on traditional medicine on the treatment of maternal and child diseases and increase quality of care on maternal and child health (MCH) service delivery system in Ethiopia.

Search strategy

Databases (Pub Med, Google Scholar, Research Gate, and HINARY) were searched for published studies done on Ethno-botany of medicinal plants in Ethiopia. Some studies were also identified through a manual Google search. No restriction was applied on the year of publication, methodology, or study subjects. Primary search terms were “maternal and child health review”, “Ethiopia”, “medicinal plants”, and “Ethno botany”.

Inclusion/exclusion criterion

Studies which do not contain full information about Ethno botany (method of preparation, growth form, plant part used, route of administration), surveys which did not address maternal and child health illness as a disease treated traditionally by practioners were excluded. Plants which are out of flora list of Ethiopia were also excluded from this review.

Data abstraction

The authors screened the articles based on the inclusion/exclusion criteria. The details of medicinal plants were extracted from each study using an abstraction forms: Scientific, Family and Local name, habit of plant, plant part used, methods of preparation, specific use and route of administration (Table 1).

Table 1: List of traditional medicinal plant species used to treat maternal and child health illnesses in Ethiopia.

Literature search results

The search of the Pub Med, Google Scholar, Research Gate, and HINARY databases and Google provided a total of 350 studies. After adjustment for duplicates, 105 remained. Of these, 40 studies were discarded, since after review of their titles and abstracts, they did not meet the criteria. .The full texts of the 66 studies were reviewed in detail. Finally, 38 studies were included in the review (Figure 1).

Figure 1: Flow diagram of study selection.

Study characteristics

Methodological validity of all the reviewed articles were checked prior to inclusion in the review by undertaking critical appraisal using a standardized instrument adapted from [8]. These studies differed significantly in the number of plants identified. From these 38 articles, almost all were conducted to assess the Ethno-botany of medicinal plants used to treat human diseases. All the studies were conducted in different parts of Ethiopia and are qualitative and mixed type. The studies used purposive sampling to select study articles. The detailed description of each plants collected from different studies is given below (Table 1).

Method of preparation and route of administration

Traditional medicinal practioners in Ethiopia apply different techniques of preparation like drying, crushing, concoction, decoction and eating with some other plants or animal products (Table 1). They use simple methods and equipments during their remedy preparation. Of the routes commonly used to administer remedies in the treatment of maternal and child health illnesses, oral route was the common route which consists 71 (73.13%) followed by dermal 6 (6.18%) way of administration. About 6% of the medicinal plants among 103 reviewed from published articles, the rout of administration is not specified (Figure 2).

Figure 2: Rout of administration of medicinal plants for the treatment of maternal and child health illnesses in Ethiopia.

Maternal and child health illnesses treated by traditional medicinal plants

In this study, the investigators were intended to deal both maternal and child health disease treatments of traditional medicinal plants. Based on the information reviewed on published research results, medicinal plants which were abundant for the treatment of retained placenta 24 (24.72%) species followed by treatment of abortion, infertility in women, Menstrual disorder and treatment of Rh disease which comprise the same 6(6.18%) plant species (Table 2).

Table 2: Maternal and child health illnesses diseases treated by traditional medicinal plants in Ethiopia.

Habits of medicinal plants which treat maternal and child illness

In this review paper shows that the most widely used Medicinal plants habit in the reviewed articles the collected plants found to be herbs 25 (25.75%) followed by shrubs 19 (19.57%) (Figure 3).

Figure 3: Habits of medicinal plants used for the treatment of maternal and child illness in Ethiopia.

Plant parts used in the reviewed articles

Every part of different plant species are used against a variety of diseases. In this review the commonly used plant parts were found to be root 40 (41.2%) followed by leaves 32 (32.96%), and stem bark 4 (4.12%) respectively. Among 103 reviewed medicinal plants about 7 (7.21%) were not identified their parts used for the case mentioned. In some cases, more than one organ of the same plant species, particularly a combination of parts, is used in the preparation of different therapies.

Diversity of medicinal plants in terms of families

In this paper review different families of medicinal plants were collected from published research articles. Among them Fabaceae is the most dominant family that holds 8 (7.77%) plant species followed by Solanaceae having 6 (5.82%) species and Cucurbitaceous having 6 (5.82%) species. From the documented medicinal plants 7 (6.79%) plant species at which their family was not clearly stated in the reviewed papers (Table 3).

Table 3: Diversity of medicinal plants in terms of families used for the treatment of maternal and child health diseases in Ethiopia.

Based on this systematic review, there is plant species used for food and drink purpose in addition to traditional treatment of maternal and child illnesses. Solanaceae, Berbere (local name) [7], Boraginaceae Wanza (local name) [9], Phytolaccaceae Indod (local name) [10] Rhamnaceae, Gesho (local name) [11] Aloaceae, Ret (local name) [12].

Discussion

This review indicated that about 103 plant species find applications by the traditional medicinal practitioners of Ethiopia to treat maternal and child health illnesses. Of the plants used traditionally, none of them were proven scientifically which shows the less attention given to the problem and the traditional practitioners in general. According to this review there is high species diversity of medicinal plants used which may be due to the climate variation that exists with the different parts of Ethiopia. In this study based on diversity of medicinal plants, Fabaceae is the most dominant family that holds 8 (8.24%) plant species followed by Solanaceae having 6 (6.18%). Similarly, a study done in Nigeria 22.5% [13], Afar [4], Harare regional State [14], Fiche Town [15], southern region, Konta [15], four districts of Jimma Zone 625% [16], Dire Dawa (8.5%) [17], Benishangul Gumuz (8.3%) [9] and Chifra District, Afar Region15% [18], evidenced this.

In this review, the commonly used plant part was found to be root 41.2%. Similarly the study conducted in Tanzania [19], Bale zone (35.71%) [20], South Omo (40%) [8], Benishangul Gumuz (39%) [9], Shewa Zone, ‘Boo sat’ sub-district 38% (48) and Chilga District 89% [12] dominant plant part used by traditional healers. On the other hand leaf is the most plant part used by traditional healers in the studies conducted in 57.2% Harari regional state (48%) [4,14] Afar 52% (14), Fiche Town (34.68%) [21], Tehuledere district, South Wollo (50%) [22], in Dire Dawa (29.4 %) [19], Gamo Gofa (44%) [23], Mirab-Badwacho district (41%) [24], Nekemt town 35% [25] and Alma-Ata, Southern Tigray 52% [26].The reason for this difference is might be due to knowledge (awareness) of traditional healers, geographical difference, and availability of plant parts in the area.

Based on this study, the most widely used medicinal plants growth forms harvested in the reviewed articles found to be herbs (26%). This result is similar with the study conducted in Uganda 51.9% [27], Nigeria (68.5%) [16], Uganda 80% (55), Delanta 52.6% [28], Guzman District 51% [29], Hadiya zone 52% [30], Jimma 84% and Tehuledere district, South Wollo (48%) [31] herbs were dominantly used. Whereas shrub had highest dominancy in studies conducted Shewa Zone, ‘Boo sat’ sub-district 46% [19], Abaya district, Borena Zone 48.8% [22] and Dasa forest, Tigray 48.8% [32] and study in South Omo trees 29% [8] highly used. The reason for this difference is it might be due to the plant species exhibit high level of abundance and easy to access them. This review revealed that, most commonly route of administration is internal particularly oral that accounted for 71%.This was similar with the studies conducted in Nigeria (84.6) [33] Mexico 26% [34] and Uganda 100% [35].

Conclusions

The plant parts used for treatment of maternal health and child illness in this review was found to be root followed by leaves and it was unlike with other ethno-botanical studies which were leaf was the dominant plant part used and the common rout of administration was through orals. Most of the medicinal plants in this review were herb. The most common maternal illness treated by medicinal plant was retained placenta and whereas in children milk feeding diarrhoea and Kwashiorkor.

Recommendations

From this review the authors suggested to carry out similar studies in areas not previously covered in order to get a full picture of the country’s medicinal plants potential for a particular disease like maternal illness. There is a need to conduct clinical trials to support traditional claims and to analyse cellular and molecular mechanisms involved.

There should be photochemical analysis in order to determine the bioactive component which could heal the disease.

The combination effect of traditional medicinal plants (pooled effect of medicinal plants) on maternity health and other health problems should be studied. In this review, some papers were incomplete so for those authors it is better to incorporate some family names, local names, etc. for better work.

Ethical approval and consent to participate

Not applicable

Consent for publication

Not applicable

Availability of data and material

No additional data are required; all information is clearly stated in the main manuscript.

Competing interests

The authors have declared that there is no competing interest.

Funding

No funding was obtained for this study.