Ethnonutritional and Medicinal Plant Knowledge and Practices for Postpartum Maternal Healthcare in Yoto Prefecture, Togo: An Ethnopharmacological Study

Abstract

Introduction: The postpartum period is a critical phase for maternal health, particularly in sub-Saharan Africa. In Togo, modern healthcare coexists with deeply rooted, yet largely undocumented, endogenous knowledge systems for postpartum care. This ethnopharmacological and ethnonutritional heritage, vital for restoring maternal vitality, faces erosion and lacks integration with biomedicine, posing potential safety risks. This study aimed to systematically document, analyze, and evaluate the traditional knowledge governing postpartum healthcare in the Yoto prefecture of Togo. Methods: A cross-sectional, mixed-methods ethnopharmacological study was conducted from July to September 2024. Semi-structured interviews were administered to 305 informants (traditional healers, birth attendants, mothers, and elders) selected via purposive and snowball sampling. Data were analyzed using qualitative thematic content analysis to understand local etiologies and quantitative ethnobotanical indices (Use Value, UV; Informant Consensus Factor, ICF) to assess knowledge consensus. A literature review was performed to assess the pharmacological plausibility and toxicological risks of key species. Results: The local postpartum care model is a coherent system based on the perceived vulnerability of the new mother, focusing on healing an internal wound (88.9%), "restoring blood" (83.6%), and "warming the body" (84.6%). We documented over 21 plant taxa, with leaves (76.5%) and decoctions (63.5%) being the most frequent preparations. An exceptionally high ICF (0.99) was found for all three main therapeutic categories (uterine cleansing, anti-anemic, and wound healing), indicating a highly robust, shared knowledge system. Key species identified by high Use Value included Tetrapleura tetraptera (UV=0.87), Moringa oleifera (UV=0.83), and Alstonia boonei (UV=0.76). A state of medical pluralism was confirmed: 89.8% of women use modern health facilities, yet only 14% discuss their traditional remedy use with providers. Conclusion: The traditional postpartum knowledge in Yoto is a sophisticated system with high pharmacological plausibility for many practices. However, this study identifies significant public health risks, notably the use of potentially hepatotoxic plants (A. boonei) and the intensive use of antiplatelet-rich spices (e.g., Zingiber officinale) that may exacerbate postpartum hemorrhage. The profound communication gap between traditional and modern systems creates a dangerous blind spot. Urgent pharmacological validation and culturally competent communication strategies are required to integrate these systems safely and effectively.