The effect of traditional birth attendant training on maternal and neonatal care

Miller, Peter C.; Rashida, Gul; Tasneem, Zeba; Haque, Minhaj ul

doi:10.1016/j.ijgo.2011.12.020

Cited by 21 publications

(19 citation statements)

References 11 publications

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“…Future research should investigate combined social and medical models. Despite the concerns regarding such integration, appropriately trained traditional healers are helpful to promote health among the rural communities in LMIC (Freeman and Motsei, 1992;Miller et al, 2012). Infectious diseases still add to the out-of-pocket health expenditure for older people in LMIC.…”

Section: Need For Equitable Health Servicesmentioning

confidence: 99%

Nature and determinants of out-of-pocket health expenditure among older people in a rural Indian community

Brinda

Rajkumar

Enemark

et al. 2012

Int. Psychogeriatr.

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Section: Need For Equitable Health Servicesmentioning

confidence: 99%

Nature and determinants of out-of-pocket health expenditure among older people in a rural Indian community

Brinda

Rajkumar

Enemark

et al. 2012

Int. Psychogeriatr.

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“…Frontline health workers include volunteer community health workers, traditional birth attendants (TBAs), as well as a variety of other paid paraprofessionals (eg, health extension workers and lady health workers) who attend women during pregnancy or during the birth and/or provide health education. It has been shown that the extension of maternal and newborn health care by trained health workers yields improved care provision and self‐care behaviors and often contributes to better birth outcomes and reduced neonatal mortality . While most studies have shown positive outcomes, some have not.…”

Section: Introductionmentioning

confidence: 99%

“…Health worker training programs have used a number of strategies to evaluate and demonstrate change in health workers’ skills and knowledge. Evaluation efforts have entailed (solely or in combination) pre‐ and posttraining knowledge tests, observation of skills by trainers, objective simulated clinical examinations, health worker self‐reports, and interviews with end users (community members who are the intended recipients of the care/education) . Some have also conducted evaluations a while after the posttraining to assess retention of knowledge and skills over time .…”

Section: Introductionmentioning

confidence: 99%

Knowledge and Skills Retention Among Frontline Health Workers: Community Maternal and Newborn Health Training in Rural Ethiopia

Gobezayehu¹,

Mohammed²,

Dynes³

et al. 2014

J Midwife Womens Health

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Introduction We examined the degree to which the skills and knowledge of health workers in Ethiopia were retained 18 months after initial maternal and newborn health training and sought to identify factors associated with 18‐month skills assessment performance. Methods A nonexperimental, descriptive design was employed to assess 18‐month skills performance on the topics of Prevent Problems Before Baby Is Born and Prevent Problems After Baby Is Born. Assessment was conducted by project personnel who also received the maternal and newborn health training and additional training to reliably assess health worker performance. Results Among the 732 health workers who participated in maternal and newborn health training in 6 rural districts of the Amhara and Oromia regions of Ethiopia (including pretesting before training and a posttraining posttest), 75 health extension workers (78%) and 234 guide team members (37%) participated in 18‐month posttest. Among health extension workers in both regions, strong knowledge retention was noted in 10 of 14 care steps for Prevent Problems Before Baby Is Born and in 14 of 16 care steps of Prevent Problems After Baby Is Born. Lower knowledge retention was observed among guide team members in the Amhara region. Across regions, health workers scored lowest on steps that involved nonaction (eg, do not give oxytocin). Educational attainment and age were among the few variables found to significantly predict test performance, although participants varied substantially by other sociodemographic characteristics. Discussion Results demonstrated an overall strong retention of knowledge and skills among health extension workers and highlighted the need for improvement among some guide team members. Refresher training and development of strategies to improve knowledge of retention of low‐performing steps were recommended.

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“…Our findings can be compared with others from the literature in Guatemala and elsewhere. For example, several studies have demonstrated that lay midwives can be trained to provide some elements of neonatal care with improvements in selected outcomes, including early neonatal referrals 13–17. A large multisite trial that included Guatemala trained lay midwives and other community-based providers on essential newborn care and neonatal resuscitation, it reduced stillbirth but not neonatal death rate and did not assess for changes in neonatal referral patterns 28.…”

Section: Lessons and Limitationsmentioning

confidence: 99%

“…In this project, our goal was to use this existing practice network of lay midwives and mHealth platform to improve the quality of care for neonates. Several studies have demonstrated that lay midwives in various contexts can be trained to provide elements of neonatal care with improvements in outcomes, including early neonatal referrals 13–17. In addition, others have studied using mHealth to improve care for neonates in low resource settings.…”

Section: Introductionmentioning

confidence: 99%

Working with lay midwives to improve the detection of neonatal complications in rural Guatemala

et al. 2020

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BackgroundGlobally most neonatal deaths occur within the first week of life and in low-income and middle-income countries. Strengthening health system linkages for frontline providers—such as lay midwives providing home-based obstetrical care—may improve neonatal outcomes in these settings. Here, we conducted a quality improvement study to increase the detection of neonatal complications by lay midwives in rural Guatemala, thereby increasing referrals to a higher level of care.MethodsA quality improvement team in Guatemala reviewed drivers of neonatal health services provided by lay midwives. Improvement interventions included training on neonatal warning signs, optimised mobile health technology to standardise assessments and financial incentives for providers. The primary quality outcome was the rate of neonatal referral to a higher level of care.ResultsFrom September 2017 to September 2018, participating midwives attended 869 home deliveries and referred 80 neonates to a higher level of care. A proportion control chart, using the preintervention period from January to September 2017 as the baseline, showed an increase in the referral rate of all births from 1.5% to 9.9%. Special cause was obtained in January 2018 and sustained except for May 2018. The proportion of neonates receiving assessments by midwives in the first week of life increased to >90%. A trend toward an increasing number of days between neonatal deaths did not attain special cause.ConclusionsStructured improvement interventions, including mobile health decision support and financial incentives, significantly increased the detection of neonatal complications and referral of neonates to higher levels of care by lay midwives operating in rural home-based settings in Guatemala. The results show the value of improving the integration of lay midwives and other first responders into neonatal systems of care in low-resource settings.

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The effect of traditional birth attendant training on maternal and neonatal care

Abstract: SMART Dai training seemed to be an important factor in the significant reduction in perinatal mortality in the CBI areas. Properly trained TBAs can substantially contribute to improved delivery outcomes.

Cited by 21 publications

References 11 publications

Nature and determinants of out-of-pocket health expenditure among older people in a rural Indian community

Nature and determinants of out-of-pocket health expenditure among older people in a rural Indian community

Knowledge and Skills Retention Among Frontline Health Workers: Community Maternal and Newborn Health Training in Rural Ethiopia

Working with lay midwives to improve the detection of neonatal complications in rural Guatemala

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