New insights into the indigenous knowledge of the uses of the common stinging nettle (Urtica massaica Mildbr.) in Rwanda

AbstractThe common stinging nettle (Urtica massaica Mildbr., ‘Igisura’) is one of the popular plants used for multiple purposes in Rwanda. This study aimed to get more insights into indigenous knowledge of the multiple uses of this plant in Rwanda. It was conducted in eleven administrative districts in September 2021. A semi-structured questionnaire was used to conduct in-depth interviews with 124 respondents who were chosen using the snowball sampling technique from locations where the stinging nettle grows or has been domesticated. In addition to face-to-face interviews, personal observations, and group discussions were organized at visited sites. Data were analyzed using SPSS. The uses of the common stinging nettle plant can be grouped into five categories: 1. Human medicine, 2. Veterinary medicine, 3. Human nutrition, 4. Animal feeding, and 5. Others. The stinging nettle is used in the form of cooked leaves (47%), leaf powder (39%), boiled leaves (8%), decoction (4%), infusion (1%), and fibers (1%). Stomach ulcers (37%) and hypertension (15%) are the most predominant diseases treated by stinging nettle products. Nearly all respondents (98%) agreed that domesticating the stinging nettle was important and indicated that they would be ready to grow it if they were assured of the market. Nettle products are widely sought to improve the health and well-being of both humans and animals. Yet, they are still scarce on the market. Hence, there is a need to promote the domestication of stinging nettle to increase its production and availability

Quantifying and valuing community health worker time in improving access to malaria diagnosis and treatment

Background: Community health workers (CHWs) are members of a community who are chosen by their communities as first-line, volunteer health workers. The time they spend providing healthcare and the value of this time are often not evaluated. Our aim was to quantify the time CHWs spent on providing healthcare before and during the implementation of an integrated programme of diagnosis and treatment of febrile illness in three African countries. Methods: In Burkina Faso, Nigeria and Uganda, CHWs were trained to assess and manage febrile patients in keeping with Integrated Management of Childhood Illness recommendations to use rapid diagnostic tests, artemisinin-based combination therapy and rectal artesunate for malaria treatment. All CHWs provided healthcare only to young children usually under 5 years old, and hence daily time allocation of their time to child healthcare was documented for one day (in the high malaria season) before the intervention and at several time points following the implementation of the intervention. Time spent in providing child healthcare was valued in earnings of persons with similar experience. Results: During the high malaria season of the intervention, CHWs spent nearly 50 minutes more in daily healthcare provision (average daily time 30.2 minutes before the intervention versus 79.5 minutes during the intervention; test for difference in means p< 0.01). On average, the daily time spent providing healthcare during the intervention was 55.8 minutes (Burkina Faso), 77.4 minutes (Nigeria) and 72.2 minutes (Uganda). Using the country minimum monthly salary, CHWs time allocated to child healthcare for one year was valued at USD 52 in Burkina Faso, USD 295 in Nigeria and USD 141 in Uganda. Conclusion: CHWs spend up to an hour and a half daily on child healthcare in their communities. These data are informative in designing reward systems to motivate CHWs to continue providing good quality services

Quantifying and Valuing Community Health Worker Time in Improving Access to Malaria Diagnosis and Treatment

This work was supported by the UNICEF/UNDP/World Bank/WHO/Special Programme for Research & Training in Tropical Diseases, World Health Organization, Geneva, Switzerland (project ID number A80553 [Burkina Faso]; A80550 [Nigeria]; and A80556 [Uganda]) through funds made available by the European Commission (FP7) for research to improve community access to health interventions in Africa

Impact of improving community-based access to malaria diagnosis and treatment on household costs

Background: Community health workers (CHWs) were trained in Burkina Faso, Nigeria and Uganda to diagnose febrile children using malaria rapid diagnostic tests (RDTs), treat positive malaria cases with artemisinin combination treatment (ACTs) and those who could not take oral medicines with rectal artesunate. We quantified the impact of this intervention on private household costs for childhood febrile illness. Methods: Households with recent febrile illness in a young child in previous two weeks were selected randomly before and during the intervention and data obtained on household costs for the illness episode. Household costs included consultation fees, registration costs, user fees, diagnosis, bed, drugs, food and transport costs. Private household costs per episode before and during the intervention were compared. The intervention’s impact on household costs per episode was calculated and projected to district-wide impacts on household costs. Results: Use of CHW increased from 35% of illness episodes before the intervention to 50% during the intervention (p<0.0001) and total household costs per episode decreased significantly in each country from 4.36 to 1.54 dollars in Burkina Faso, from 3.90 to 2.04 dollars in Nigeria and from 4.46 to 1.42 in dollars Uganda (all p<0.0001). There was no difference in the time used by the child’s caregiver to care for a sick child (59% before intervention vs. 51% during intervention spent 2 days or less). Using the most recent population figures for each study district, we estimate that the intervention could save households a total of 29,965, 254,268 and 303,467 dollars, respectively in the study districts in Burkina Faso, Nigeria and Uganda. Conclusions: Improving access to malaria diagnostics and treatments in malaria endemic areas substantially reduces private household costs. The key challenge is to develop and strengthen community human resources to deliver the intervention, and ensure adequate supplies of commodities and supervision. We demonstrate feasibility and benefit to populations living in difficult circumstances

Impact of improving community-based access to malaria diagnosis and treatment on household costs

Background: Community health workers (CHWs) were trained in Burkina Faso, Nigeria and Uganda to diagnose febrile children using malaria rapid diagnostic tests (RDTs), treat positive malaria cases with artemisinin combination treatment (ACTs) and those who could not take oral medicines with rectal artesunate. We quantified the impact of this intervention on private household costs for childhood febrile illness. Methods: Households with recent febrile illness in a young child in previous two weeks were selected randomly before and during the intervention and data obtained on household costs for the illness episode. Household costs included consultation fees, registration costs, user fees, diagnosis, bed, drugs, food and transport costs. Private household costs per episode before and during the intervention were compared. The intervention’s impact on household costs per episode was calculated and projected to district-wide impacts on household costs. Results: Use of CHW increased from 35% of illness episodes before the intervention to 50% during the intervention (p&lt;0.0001) and total household costs per episode decreased significantly in each country from 4.36 to 1.54 dollars in Burkina Faso, from 3.90 to 2.04 dollars in Nigeria and from 4.46 to 1.42 in dollars Uganda (all p&lt;0.0001). There was no difference in the time used by the child’s caregiver to care for a sick child (59% before intervention vs. 51% during intervention spent 2 days or less). Using the most recent population figures for each study district, we estimate that the intervention could save households a total of 29,965, 254,268 and 303,467 dollars, respectively in the study districts in Burkina Faso, Nigeria and Uganda. Conclusions: Improving access to malaria diagnostics and treatments in malaria endemic areas substantially reduces private household costs. The key challenge is to develop and strengthen community human resources to deliver the intervention, and ensure adequate supplies of commodities and supervision. We demonstrate feasibility and benefit to populations living in difficult circumstances

Impact of Improving Community-Based Access to Malaria Diagnosis and Treatment on Household Costs

Financial support. This work was supported by UNICEF/UNDP/World Bank/WHO/Special Programme for Research & Training in Tropical Diseases, World Health Organization, Geneva, Switzerland (project ID numbers A80553; [;Burkina Faso], A80550; [;Nigeria], and A80556; [Uganda]) through funds made available by the European Commission (FP7) for research to improved community access to health interventions in Africa. Supplement sponsorship. This article appears as part of the supplement “Malaria in Highly Endemic Areas: Improving Control Through Diagnosis, Artemisinin Combination Therapy, and Rectal Artesunate Treatment,” sponsored by the World Health Organization

New insights into the indigenous knowledge of the uses of the common stinging nettle (<i>Urtica massaica</i> Mildbr.) in Rwanda

The common stinging nettle (Urtica massaica Mildbr., ‘Igisura’) is one of the popular plants used for multiple purposes in Rwanda. This study aimed to get more insights into indigenous knowledge of the multiple uses of this plant in Rwanda. It was conducted in eleven administrative districts in September 2021. A semi-structured questionnaire was used to conduct in-depth interviews with 124 respondents who were chosen using the snowball sampling technique from locations where the stinging nettle grows or has been domesticated. In addition to face-to-face interviews, personal observations, and group discussions were organized at visited sites. Data were analyzed using SPSS. The uses of the common stinging nettle plant can be grouped into five categories: 1. Human medicine, 2. Veterinary medicine, 3. Human nutrition, 4. Animal feeding, and 5. Others. The stinging nettle is used in the form of cooked leaves (47%), leaf powder (39%), boiled leaves (8%), decoction (4%), infusion (1%), and fibers (1%). Stomach ulcers (37%) and hypertension (15%) are the most predominant diseases treated by stinging nettle products. Nearly all respondents (98%) agreed that domesticating the stinging nettle was important and indicated that they would be ready to grow it if they were assured of the market. Nettle products are widely sought to improve the health and well-being of both humans and animals. Yet, they are still scarce on the market. Hence, there is a need to promote the domestication of stinging nettle to increase its production and availability.</p