|Year : 2016 | Volume
| Issue : 4 | Page : 215-219
Ritual hot bath (wankan jego) in Kano: Are they still practicing? What are the implications?
Ayyuba Rabiu, Ibrahim Garba, Idris Sulaiman Abubakar
Department of Obstetrics and Gynaecology, Bayero University Kano, Aminu Kano Teaching Hospital, P.M.B. 3011, Kano, Nigeria
|Date of Web Publication||21-Dec-2016|
Department of Obstetrics and Gynaecology, Bayero University Kano, Aminu Kano Teaching Hospital, P.M.B. 3011, Kano
Background: Postpartum ritual hot bath is one of the harmful cultural beliefs commonly practiced in Northern Nigeria. It is linked with health hazards especially among women with hypertensive disorders of pregnancy. Methodology: It was a cross-sectional study conducted among 199 pregnant women over the period of 3 months. Ethical approval was obtained from The Kano State Ethical Committee. Questionnaire was administered among consenting pregnant women. Information on sociodemographic characteristics and practice of hot bath was obtained. Data were analyzed with SPSS version 17 computer software (SPSS Inc., SPSS Statistics for Windows, Chicago, IL, USA). Results: One hundred and ninety-nine pregnant women were recruited for the survey. The mean age ± standard deviation was 28.09 ± 5.55 years. The rate of hot bath was 56.80% and the days spent taking the hot bath ranged from 4 to 40 days. An average of 195.41 ± 96.050 Naira was spent on firewood per day for the hot bath. The method of boiling the water was mainly the use of firewood 87 (78.40%). They mainly used leaves 76 (68.50%) and towel 35 (31.50%) for bathing. The responsibility of the cost of the hot bath was mainly on husband 102 (91.90%). The hot bath was enforced mainly by the parents 68 (61.30%). Up to 82 (73.90%) of the respondents were ready to abandon the hot bath if alternatives such as drugs are provided. Conclusion: The prevalence rate of hot bath was 56.80%. The burden of its financial implications lies mainly on husbands leading to other social and financial problems.
Keywords: Northern Nigeria, postpartum, ritual hot bath
|How to cite this article:|
Rabiu A, Garba I, Abubakar IS. Ritual hot bath (wankan jego) in Kano: Are they still practicing? What are the implications?. Sahel Med J 2016;19:215-9
|How to cite this URL:|
Rabiu A, Garba I, Abubakar IS. Ritual hot bath (wankan jego) in Kano: Are they still practicing? What are the implications?. Sahel Med J [serial online] 2016 [cited 2019 Oct 13];19:215-9. Available from: http://www.smjonline.org/text.asp?2016/19/4/215/196368
| Introduction|| |
Postpartum maternal health care is of immense importance to the well-being of the mother and influences the health status of both the mother and the child.  In Northern Nigeria, where postpartum cultural beliefs and practices are ubiquitous, ritual hot bath is still prevailing among Hausa-Fulani ethnic group and the practitioners ignorantly believed to be protective against body swelling, foul smelling lochia, and perineal pains following delivery.  The art of bathing with water has been essential to one's good health and peace of mind since time immemorial.  However, where hot water is used for bathing consistently for a prolonged period following delivery may endanger the health status of the new mother. A hot bath is especially dangerous for individuals suffering from a medical history of heart disease, low or high blood pressure, circulatory system problems, or pregnant women and their fetuses. A study in Zaria, North Western Nigeria, showed that health hazards associated with hot bathing include third-degree burns, infections, cardiomegaly, and peripartum cardiac failure. 
Hot bath "wankan jego" entails bathing with hot water twice a day the following delivery for 40-120 days depending on whether the childbirth is the first or subsequent deliveries. For the first birth, the hot birth is extended up to 120 days.  The new mother takes two scalding hot baths each day using a bundle of leaves immersed in the hot water, to splash on her body. It is usually assisted by an elderly woman. After taking the bath, she remains in a well-heated room with a fire or fire glowing underneath a specially constructed dried mud bed, which can retain heat for several hours.  The genesis of hot bath is lost in the mists of antiquity and mythology. An anecdotal report revealed that following pregnancy and delivery, a mother can only go back to her prepregnancy state with little or no complications after performing hot bath. Hence the reason why this practice of hot bath is emphasized usually by the parent in this community.
Not only the Northern part of Nigeria, even in the South Eastern part, a variant of hot bath is believed to be practiced by the parturient mothers. Okeke and colleagues  reported that 80.2% of the parturient mothers apply hot compresses on the lower abdomen following childbirth. This was believed by the parturients to enhance lochia drainage and involution of the uterus.
Ritual hot bath is a culture that is bedeviled with myth and misconceptions. Apart from the lasting financial consequences, it can also cause marital disharmony especially where the new mother is against the wishes of her in-laws of practicing hot bath.
We aimed to reveal the prevalence rate of the hot bath, its implications, and the enforcement of the practice in our community.
| Methodology|| |
It was a cross-sectional study conducted among 199 pregnant women over the period of 3 months from February 1 to April 30, 2015. Ethical approval was obtained from The Kano State Ethical Committee. Questionnaire was structured and pretested before administering to all consenting pregnant women. The questionnaire comprised both closed- and open-ended questions and was administered by trained research assistants over the period of the study. Information requested on the questionnaire included sociodemographic characteristics, practice of hot bath "wankan jego," its financial implications, and other consequences. Data were analyzed with SPSS version 17 computer software (SPSS Inc., SPSS Statistics for Windows, Chicago, IL, USA). Chi-square test was used for categorical data, and the value P ≤ 0.05 was considered statistically significant.
| Results|| |
One hundred and ninety-nine pregnant women were recruited for the survey. The mean age ± standard deviation (SD) of the respondents was 28.09 ± 5.55 years. The modal age was 30 years. The age group of 25-29 was the highest represented 63 (31.70%) followed by 18-24 years 49 (24.60%). The least represented age group was 45-49 years 1 (0.50%) as seen in [Table 1].
The mean pregnancy ± SD was 5.30 ± 3.15. Majority of the respondents had at least five pregnancies 105 (52.80%). Primigravidae were the least represented 13 (6.50%) [Table 1].
The highest levels of education for most of the respondents were secondary 58 (29.10%) and tertiary 54 (27.10%). The least attended educational was primary 27 (13.60%). For their husbands, a significant proportion 95 (47.70%) attended tertiary level of education [Table 1].
Whopping figures of the respondents were business women 81 (40.70%). Home managers constituted 47 (23.62%). Their husband's occupations also were mainly business 85 (42.71%) and civil services 60 (30.15%) [Table 1].
The prevalence rate of hot bath "wankan jego" was 56.80% and the days spent taking the hot bath ranged from 4 to 40 days with a mean ± SD of 31.61 ± 11.00 days [Table 2]. The modal age was 40 days. An average of 195.41 ± 96.050 Naira was spent on firewood per day for the hot bath.
Up to 98 (97.03%) believed nothing will happen to them if the rituals are abandoned but the remaining 3 (2.97%) believed something bad will happen to them.
There was no statistically significant association between the age groups and the practice of hot bath (χ2 = 3.721, P = 0.590). Furthermore, level of education of either the wife or the husband was not associated with the practice of hot bath (χ2 = 3.082, P = 0.544; χ2 = 3.621, P = 0.605, respectively).
Only few of the respondents 3 (13.00%) performed hot bath after miscarriage and a staggering 87 (77.70%) were willing to perform hot bath when next they deliver [Table 2].
Reasons why they performed hot bath included "it makes me healthier 53 (47.70%), it is our culture 37 (33.30%), and it is a religious belief 5 (4.50%) " [Table 2].
A higher proportion of the respondents got water for the hot bath from the house tap 50 (45.00%). Others were from the house well 46 (41.40%) and water sellers 13 (11.70%) [Table 3].
Methods of boiling the water included the use of firewood 87 (78.40%), kerosene stove 8 (7.20%), and electric stove 9 (8.10%) [Table 3]. They mainly used leaves 76 (68.50%) and towel 35 (31.50%) for the bathing. Few of them 36 (32.40%) added herbs in hot water. Reasons given were mainly as medication 88 (79.28%), and culture 13 (11.72%) [Table 3]. The responsibility of the cost of the hot bath was mainly on husband 102 (91.90%) but few 6 (5.40%) had complaints from the person responsible for the payments. The hot bath was enforced mainly by the parents 68 (61.30%) and mothers-in-law 11 (9.90%) with little assistance 3 (2.70%) in performing the ritual [Table 3].
Few of the respondents 2 (1.80%) reported dizziness after performing the hot bath and giving the baby water to drink 3 (2.70%) [Table 4].
Up to 82 (73.90%) of the respondents were ready to abandon the hot bath if alternatives such as drugs are to be provided.
| Discussion|| |
We found the prevalence rate of hot bath as 56.80%. This is high and alarming when we look at the level of education and women's awareness of harmful traditional practices in Kano. Zubairu et al.  earlier reported a rate of hot bath of 86% in Dambare Village, a remote area from Kano suburb. The number of days (40) spent performing the hot bath and the average amount of 195.41 Naira daily for buying the firewood have a great economic impact on the family daily life especially with the level of poverty of at least 61% in Northern Nigeria.  Although many (97.03%) believed nothing bad of health concern will affect them when they abandoned the practice of hot bath, their massive participation in the practice of the hot bath and their willingness to take hot bath when next they deliver will certainly deter total elimination of the practice in our community.
Our study showed no statistically significant association between the age groups, level of education of either the wives or the husbands with the practice of hot bath (χ2 = 3.721, P = 0.590; χ2 = 3.082, P = 0.544; χ2 = 3.621, P = 0.605, respectively). The study also revealed practice of hot bath is mainly following delivery of a pregnancy that attained the age of viability, where pregnancy is ended as miscarriage only a few (13.00%) performed ritual hot bath.
Methods of obtaining the water for hot bath confer considerable challenges coupled with the money spent in boiling it. These will certainly affect the living standard negatively especially with a poverty level of about 37% in most urban areas in Northern Nigeria. 
The respondents also believed hot bath makes them healthier (47.70%); it is their culture (33.30%) and is a religious injection (4.50%). Zozulya  reported that certain pregnancy associated complications such as eclampsia, especially postpartum are treated with ritual hot bath among others. What an unfortunate belief! A hot bath can only aggravate and worsen conditions such as eclampsia and other hypertensive disorders of pregnancy. 
Husbands usually bear the burden of the hot bath by procuring the firewood and water. Where the husband is financially handicapped, the demands from the hot bath might cause marital disharmony and other social problems as evidenced by our findings where 61.30% of the respondents were enforced to take the hot bath by their parents.
Alternatives like drugs will be readily substituted for the ritual hot bath by 73.90% of the pregnant women; where pregnant women are properly health educated on the complications that may arise from ritual hot bath and counseled on its nonbenefits, total elimination of this harmful practice will soon be accomplished in the near future.
| Conclusion|| |
The prevalence rate of hot bath is 56.80%, which was alarming considering the level of awareness of its harmful effects in our environment. The burden of its financial implications lies mainly on the husbands leading to other social and financial problems. Health educations at antenatal care clinic with provision of hot bath substitutes will help in total elimination of this practice.
Questionnaire-based study and nonresponses to some of the questions are some of the limitations of the study.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
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[Table 1], [Table 2], [Table 3], [Table 4]