Impact of Training traditional birth attendants on maternal mortality and morbidity in Sub-Saharan African countries

Abstract

This paper presents discussion on impact of training traditional birth attendants (TBAs) on overall improvement of reproductive health care with focus on reducing the high rate of maternal and new-born mortality in rural settings in sub-Saharan Africa. The importance of TBAs for years has been denied by professional western trained health practitioners and other scientists until during the late 1980s, when World Health Organization through Safe motherhood 1987 found TBAs have a significant role in reducing maternal and newborn mortality. Trained TBAs in sub-Sahara Africa can have positive impact on reducing maternal and new-born mortality if the programme is well implemented with systematic follow-up after training. This could be done through joint meeting between health workers and TBAs as feed and learning experience from problem encountered in process of providing child delivery services. TBAs can help to break socio-cultural barriers on intervention on reproductive health programmes. However projects targeting TBAs should not be of hit and run; but gradually familiarize with the target group, build trust, transparency, and tolerance, willing to learn and creating a better relationship with them. In this paper, some case studies are described on how trained TBAs can be fully utilized in reducing maternal and new-born mortality rate in rural areas. What is needed is to identify TBAs, map their distribution and train them on basic primary healthcare related to child deliveries and complications which need to be referred to conventional health facilities immediately.

Experience of Implementation of Safe Motherhood Program with Traditional Health Practitioners in Central Zone (Singida and Dodoma region) of Tanzania

“…For example, Kayombo [18], has argued that the MCH Coordinators in the two regions expressed that traditional midwives if harnessed well were one of the important potential resources which the health sector has not developed and prepared it. Exploiting this potential resource can help to reduce the current high maternal morbidity and infant mortality [6,8,19,36]. This argument was amplified by the Mvumi hospital MCH coordinator who stressed that only 20% of the total child deliveries to the villages which surround the Mvumi hospital were done in Mvumi hospital and the dispensaries which are around the hospital [16].…”

“…Hence efforts required identifying the THPs and their specific location, learning what they are doing and seeing in what ways the new knowledge health care will be imparted, so that it yields the desired results of improvement of health for all at PHC level and especially in reducing maternal morality. It has to be acknowledged that THPs are potential human resources for intervention programs in the community because these are cultural accepted health practitioner by the community where they live [4][5][6][7][8]18,19].…”

“…In Tanzania, despite the efforts done by the government through the use of maternal child health care that provide combination of preventive and curative health services for women and children, antenatal and postnatal care, normal deliveries, immunization, child spacing, nutrition, education, malaria, chemosuppression for pregnant women, children and treatment of simple diseases [10,11,20,23,[26][27][28][29][30]], Tanzania's maternal mortality rate continues at an unacceptably high level [8,10,11,19,20,23,28]. While maternal mortality figures vary widely by source and are highly controversial, the best estimates for Tanzania suggest that roughly between 7,500 and 15,000 women and girls die each year due to pregnancy related complications [9,11].…”

“…The available facilities lack skilled personnel and, drugs, gloves and other equipments that can assist save child delivery in these facilities, and therefore more child bearing women deliver at home with the assistance of mother in law, aunt, sister-inlaw, relatives and traditional midwives [6,18,19]. Similar situation to other health problems most people visit traditional health practitioners.…”

“…In order to reduce maternal mortality as a way of meeting the 5th millennium goal which aims to reduce maternal mortality by three quarters between 1990 and 2015 developing countries are left with one option of using the omni present traditional health practitioners and especially the traditional midwives. THs and traditional midwives are already an expert [6,9,18,19] what is needed is to improve their skills through training and supervising with skilled personnel on safe child deliveries.…”