Tereza Nyamwenge2026-07-242026-07-242026-06-15https://hdl.handle.net/20.500.11951/2213Complementary and alternative medicine (CAM) remains widely used among pregnant women in low- and middle-income countries, where cultural norms, socio-economic factors, and health system characteristics shape maternal health-seeking behaviours. Despite national efforts to regulate traditional medicine in Uganda, there is limited empirical evidence on the prevalence and determinants of CAM use in rural settings. At Nagongera Health Centre IV, the extent and drivers of CAM utilization among pregnant women remain inadequately documented. This study aimed to determine the utilization of CAM and its associated factors among pregnant women attending antenatal care (ANC) at Nagongera Health Centre IV. A facility-based cross-sectional study using a convergent parallel mixed-methods design was conducted among 405 pregnant women, recruited consecutively as they attended ANC services (response rate: 92%). Quantitative data were analyzed using SPSS version 26, while qualitative data from 10 in-depth interviews were analyzed thematically. The prevalence of CAM use during pregnancy was 52.6% (213/405). Herbal medicine was the most commonly used modality (67.1%), followed by consultation with traditional birth attendants (39.4%) and massage (34.7%). Nearly half (45.5%) of CAM users reported daily use, and 58.7% spent less than UGX 10,000 per month on CAM. Multivariate analysis showed that lower knowledge levels strongly increased the likelihood of CAM use (AOR = 2799.53; 95% CI: 61.23–127,988.60; p<0.001). Perceiving CAM as culturally embedded significantly increased odds of use (AOR = 11.57; 95% CI: 1.73–77.34; p=0.012). Family recommendations were also strongly associated (AOR = 1294.39; 95% CI: 113.42–14,771.50; p<0.001). Economic factors were significant: women from households with adequate footwear were more likely to use CAM (AOR = 2.50; 95% CI: 1.47–4.26; p=0.001), whereas households consuming three or more meals per day had lower odds of CAM use (AOR = 0.27; 95% CI: 0.17–0.43; p<0.001). Qualitative findings supported the quantitative results, highlighting cultural inheritance, peer influence, perceived effectiveness in easing labour, dissatisfaction with health facility services, and affordability as major drivers of CAM use. In conclusion, CAM utilization among pregnant women at Nagongera Health Centre IV is high and shaped by interrelated cultural, informational, and socio-economic factors. Strengthening antenatal counselling, promoting respectful maternity care, and providing culturally sensitive health education may help reduce unsafe and undisclosed CAM use.enThesis