From home deliveries to health care facilities: establishing a traditional birth attendant referral program in Kenya

Tomedi, Angelo; Stroud, S.; Maya, Tania Ruiz; Plaman, Christopher R.; Mwanthi, Mutuku A.

doi:10.1186/s41043-015-0023-z

Cited by 11 publications

(25 citation statements)

References 8 publications

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“…A paper by Maina and Kirigia ( 2015 ) shows increases in public sector deliveries post-policy, yet this finding is based on facility surveys from a subset of counties. Conversely, Tomedi et al ( 2015 ) collected data from 29 rural primary-level health facilities in Machakos County and did not show a significant increase in skilled birth attendant deliveries in a 7 month period after introduction of the policy. These two studies had a limited geographic range and highlight the need for population-based evidence.…”

Section: Discussionmentioning

confidence: 94%

The Effect of the Removal of User Fees for Delivery at Public Health Facilities on Institutional Delivery in Urban Kenya

Calhoun

Speizer

Guilkey

et al. 2017

Matern Child Health J

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Objectives In 2013, Kenya removed delivery fees at public health facilities in an effort to promote equity in access to health services and address high maternal mortality. This study determines the effect of the policy to remove user fees on institutional delivery in a population-based sample of women from urban Kenya. Methods Longitudinal data were collected from a representative sample of 8500 women from five cities in Kenya in 2010 with a follow-up interview in 2014 (response rate 58.9%). Respondents were asked about their most recent birth since 2008 at baseline and 2012 at endline, including the delivery location. Multinomial logistic regression is used, controlling for the temporal time trend and background characteristics, to determine if births which occurred after the national policy change were more likely to occur at a public facility than at home or a private facility. Results Multivariate findings show that women were significantly more likely to deliver at a public facility as compared to a private facility after the policy. Among the poor, the results show that poor women were significantly more likely to deliver in a public facility compared to home or a private facility after policy change. Conclusions for Practice These findings show Kenya’s progress towards achieving universal access to delivery services and meeting its national development targets. The removal of delivery fees in the public sector is leading to increased use of facilities for delivery among the urban poor; this is an important first step in reducing maternal death.

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Section: Discussionmentioning

confidence: 94%

The Effect of the Removal of User Fees for Delivery at Public Health Facilities on Institutional Delivery in Urban Kenya

Calhoun

Speizer

Guilkey

et al. 2017

Matern Child Health J

View full text Add to dashboard Cite

show abstract

“…The 17 studies were conducted in 12 countries in Africa, these being grouped as following: one conducted in three countries (Ethiopia, Ghana and Nigeria)(Wells et al, 2016 ), two in Ethiopia (Molla et al, 2015 ; Tesfahun et al, 2014 ), two in Ghana (Hill et al, 2015 ; Oduro‐Mensah et al, 2013 ) and one in Nigeria (Agho et al, 2016 ). Two were conducted in Kenya (Byrne et al, 2016 ; Tomedi et al, 2015 ), two in Tanzania (Kanté et al, 2015 ; Pfeiffer & Mwaipopo, 2013 ) and one each in Burkina‐Faso (De Allegri et al, 2015 ), DRC/Congo (Ntambue et al, 2016 ), Niger (Bensaïd et al, 2016 ), Rwanda (Hagey et al, 2014 ), South Africa (Haddad et al, 2016 ), Uganda (Ahumuza et al, 2016 ) and Zambia (Kyei et al, 2012 ) (Table 1 ). As indicated in Table S3 , the appraisal of the 17 studies confirmed that they could all be used in the review, as the methods sections provided sufficient detail to extract the type of information required to effectively use the MMAT tool.…”

Section: Resultsmentioning

confidence: 99%

“…Mothers’ use of TBAs remains higher than SBAs in remote areas that have few health facilities and where mobile populations have limited access to static health services (Byrne et al, 2016 ). TBAs were too far away from health centres to improve the transfer of mother to the SBAs in rural Kenyan health facilities both before and after the implementation of a free maternity care policy in 2013 (Tomedi et al, 2015 ). The finding showed that at Phomolong clinic near Kalafong Hospital in peri‐urban Pretoria (South Africa), pregnant women delayed their attendance of ANC visits until late in their pregnancy, making intervention planning difficult (Haddad et al, 2016 ).…”

Section: Resultsmentioning

confidence: 99%

Community‐ based maternal and newborn interventions in Africa: Systematic review

Nishimwe

Mchunu

Mukamusoni³

2021

Journal of Clinical Nursing

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Aim and objectives This review analysed the implementation and integration into healthcare systems of maternal and newborn healthcare interventions in Africa that include community health workers to reduce maternal and newborn deaths. Background Most neonatal deaths (99%) occur in low‐ and middle‐income countries, with approximately half happening at home. In resource‐constrained settings, community‐based maternal and newborn care is regarded as a sound programme for improving newborn survival. Health workers can play an important role in supporting families to adopt sound health practices, encourage delivery in healthcare facilities and ensure timeous referral. Maternal and newborn mortality is a major public health problem, particularly in sub‐Saharan Africa, where the Millennium Development Goals 4, 5 and 6 were not achieved at the end of 2015. Methods The review includes quantitative, qualitative and mixed‐method studies, with a data‐based convergent synthesis design being used, and the results grouped into categories and trends. The review took into account the participants, interventions, context and outcome frameworks (PICO), and followed the adapted PRISMA format for reporting systematic reviews of the qualitative and quantitative evidence guide checklist. Results The results from the 17 included studies focused on three themes: antenatal, delivery and postnatal care interventions as a continuum. The main components of the interventions were inadequate, highlighting the need for improved planning before each stage of implementation. A conceptual framework of planning and implementation was elaborated to improve maternal and newborn health. Conclusion The systematic review highlight the importance of thoroughly planning before any programme implementation, and ensuring that measures are in place to enable continuity of services. Relevant to the clinical practice Conceptual framework of planning and implementation of maternal and newborn healthcare interventions by maternal community health workers.

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“…TRADITIONAL birth attendants (TBAs) have long been used by women in East Africa to aid in childbirth (1)(2)(3)(4)(5). TBAs typically have no formal education and often engage in unregulated use of medicinal plants as well as other ritualistic but culturally acceptable practices.…”

Section: Introductionmentioning

confidence: 99%

An Open Conversation with Traditional Birth Attendants in Rural Uganda: The Potential for Collaborative Care

Yuan¹,

Cherukuri²,

Ssembatya³

et al. 2017

JGR

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Background: Imaging the World-Africa (ITWA) is a registered non-governmental organization aimed at distributing low-cost ultrasound services at health centers in rural Uganda. Yet, studies demonstrate that the majority of mothers continue to deliver with unregulated traditional birth attendants (TBAs) in their local villages. It has been suggested that the unregulated practices of TBAs has contributed to the high rate of maternal and fetal mortality. A greater understanding of the roles of TBAs in the management of pregnancy and delivery is needed. Purpose: The purpose of this report is to provide the international community with a greater understanding of TBA practices as well as an assessment of their willingness for future collaboration. Methods: Three TBAs from di erent nearby villages attended a meeting with ITWA in Kamuli District, Uganda. The meeting included an interview and an educational session. A test on the management principles of common obstetric complications was administered at the beginning and end of the meeting to assess baseline knowledge and the e ect of the interaction. Results: The meeting with the TBAs provided valuable qualitative information about TBA clinical experience, the value of TBAs to the community and TBA understanding of ultrasound. On the pre-educational test, the TBAs had a limited understanding of pregnancy complications and conditions in which it would be safer for a mother to deliver at a hospital. After the educational session, the TBAs performed statistically signi cantly better on the post-test (p=0.03).

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From home deliveries to health care facilities: establishing a traditional birth attendant referral program in Kenya

Cited by 11 publications

References 8 publications

The Effect of the Removal of User Fees for Delivery at Public Health Facilities on Institutional Delivery in Urban Kenya

The Effect of the Removal of User Fees for Delivery at Public Health Facilities on Institutional Delivery in Urban Kenya

Community‐ based maternal and newborn interventions in Africa: Systematic review

An Open Conversation with Traditional Birth Attendants in Rural Uganda: The Potential for Collaborative Care

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