Community contact persons promote utilization of obstetric services, Anambra State, Nigeria

Abstract

Community contact persons can perform a valuable role in facilitating referral of women with obstetric complications and supporting health education activities.

How the integration of traditional birth attendants with formal health systems can increase skilled birth attendance

“…Directing TBAs to promote facility services without additional activities does not increase skilled birth attendance, as shown by Kumar [63] and Schooley et al [64]. In Nigeria, TBAs initially referred 54% of women and were pleased that SBAs gave their clients "special and urgent attention" [65]; however, their promotional activities virtually ceased after 6 months. Traditional birth attendant integration mechanisms were rarely applied in isolation.…”

“…Nwakoby et al [65] reported an increase in referrals, from 0% to 54%, and Mullany et al [38] reported increased skilled birth attendance, from 5% to 48.7%, with careful selection of TBAs based on combinations of literacy, activity level, gender, self-nomination, and reputation. Notably, studies selecting TBAs exclusively by activity level or popularity changed skilled birth attendance little [14,45,61].…”

“…Gabrysch et al [48], and Skinner and Rathavy [51] reported community participation as priority for increasing compliance with TBA referrals. The integration of TBAs has been bolstered with education groups [55] and information sessions by midwife-TBA teams [50]; community committees promoting maternity care [38,42], monitoring projects [42,59], community-managed funds [44,62], and blood donation [65]; monthly meetings [60]; and women's group consultations [40].…”

“…Trained SBAs afforded special and urgent attention to clients of TBAs [65] Communication systems for appropriate triage of obstetric emergencies and improved responsiveness Phone instructions can aid TBAs to manage complications successfully, enable reports of incoming referrals, and ensure rapid triage on arrival [55]. Care is efficient though facility upgrading, increasing of staff, equipping TBAs with walkie-talkies, and dispatching ambulances [54] Inclusion of TBAs at facilities to share the work load and prioritize in settings of SBA shortages TBAs practice at facilities where SBAs are accessible when required [43,53].…”

Determining Factors of Cesarean Delivery Trends in Developing Countries: Lessons from Point G National Hospital (Bamako - Mali)

“…Likewise, the National Perinatality Program of Mali was conceived in 1994 and organised the referral system to improve the environment of perinatal care. Reported interventions at the community level focused on (1) educational activities to raise awareness of danger signs and encourage the use of obstetric services; (2) reducing geographical and financial barriers through emergency loan schemes / subvention and (3) improving transport and communication [Kandeh et al, 1997;Nwakoby et al 1997]. This policy led to an increase in cesarean delivery rates in rural district hospitals [De Brouwere, 1997], but it was very difficult to implement in large cities like Bamako.…”