Community social support roles of trained traditional birth attendants in Chongwe district, Zambia

Abstract

Although traditional birth attendants (TBAs) play key roles in providing maternal health care in many low-resource countries, there are few studies that describe the actual roles and practices of TBAs in their local communities. In addition, there remains controversy about the impact of TBAs on the reduction of maternal and infant morbidity and mortality. This paper presents the results of focus group discussions that were conducted in the Chongwe district in the Lusaka Province of Zambia. It describes the roles of trained (t)TBAs in the district. Method: The researcher used an interview guide to conduct five focus group discussions with 28 tTBAs, four mothers, two midwives, two nurses, and one village leader. The study participants were recruited using a convenience sampling approach, from four district health facilities. The focus group discussions were conducted in English, tape-recorded and then transcribed. The data were analysed using the qualitative content analysis method. Results: The main theme identified as describing the role of the tTBA was community social support. This theme was further divided into three categories: providing safe motherhood services, counselling, and health education. Each of these categories also included sub-categories. These findings do not present a view of the general population since it was conducted in only one out of 73 districts in Zambia. Conclusions: The findings from this study recommend the continued training, monitoring, evaluating and documenting of the impact of the TBAs' practices using the modified Ministry of Health TBA training curriculum and the monitoring tool during supervisions. The documentation of their impact would inform evidence-based policy formulation. The influential leaders should sustain their practice by using rural folks' wealth–ranking approach. Generally, tTBAs are likened to ‘spare wheels of cars’ which need to be ready for use in emergency situations when a tyre fails. Chongwe district should form an association to advocate for tTBAs' sustainability.