title: Comparing local perspectives on women's health with statistics on maternal mortality: an ethnobotanical study in Bénin and Gabon.
abstract: BACKGROUND
  According to the World Health Organization (WHO), reproductive health problems are the leading cause of morbidity and mortality for women in Africa. In spite of this scenario and the importance of plants in African health care, limited research has been conducted linking maternal health and plant-based medicine. The objective of our research was to examine how closely Beninese and Gabonese women's health perspectives, medicinal plant knowledge, and plant use practices reflect the statistical causes of maternal mortality.
  
  
  METHODS
  In Bénin (2011) and Gabon (2012), we conducted 87 ethnobotanical questionnaires with the corresponding collection of 800 botanical specimens. We used free-listing analysis, citation frequency and species counts to determine women's top health concerns. We also interviewed 18 biomedical healthcare providers in national hospitals and local clinics.
  
  
  RESULTS
  Informants' perceptions of the main causes of maternal suffering included malaria, infertility, and menstruation and pregnancy concerns. Women were knowledgeable on plants to treat the top causes of maternal morbidity, but knew more plants for conditions such as anemia, infertility, breast milk production, and the maintenance of menstruation and pregnancy. The biomedical staff recognized the role of traditional medicine in their patients' lives and expressed concern for herbal remedies to facilitate birth, but were restricted by national policies on advising on medicinal plant use.
  
  
  CONCLUSIONS
  Plants serve as an entry point to understanding Beninese and Gabonese women's perceptions of common health concerns and local health management strategies. Plant use practices in both countries did not closely parallel the top statistical causes of maternal mortality, but highlighted key issues such as menstruation and infertility as salient health concerns for women. More research is needed on the role of plants in women's gynecological healthcare.
authors.affiliation: Naturalis Biodiversity Center, Leiden University, Darwinweg 4, P,O, Box 9517, RA 2300 Leiden, The Netherlands. alexandra.towns@naturalis.nl.
authors.forename: Alexandra M
authors.initials: AM
authors.lastname: Towns
authors.forename: Tinde
authors.initials: T
authors.lastname: van Andel
mesh_terms: D000328:Adult; D001541:Benin; D002423:Cause of Death; D003695:Delivery of Health Care; D019448:Ethnobotany; D005260:Female; D005681:Gabon; D007722:Health Knowledge, Attitudes, Practice; D006282:Health Personnel; D006801:Humans; D007407:Interviews as Topic; D008288:Malaria / Q000188:drug therapy; D008428:Maternal Mortality; D008519:Medicine, Traditional; D008875:Middle Aged; D008517:Phytotherapy; D010946:Plants, Medicinal; D011247:Pregnancy; D011795:Surveys and Questionnaires; D016387:Women's Health / Q000706:statistics & numerical data