Abstract
BackgroundThe high rate of home deliveries conducted by unskilled birth attendants in resource-limited settings is an important global health issue because it is believed to be a significant contributing factor to maternal and newborn mortality. Given the large number of deliveries that are managed by unskilled or traditional birth attendants outside of health facilities, and the fact that there is on-going discussion regarding the role of traditional birth attendants in the maternal newborn health (MNH) service continuum, we sought to ascertain the practices of traditional birth attendants in our catchment area. The findings of this descriptive study might help inform conversations regarding the roles that traditional birth attendants can play in maternal-newborn health care.MethodsA structured questionnaire was used in a survey that included one hundred unskilled birth attendants in western Kenya. Descriptive statistics were employed.ResultsInappropriate or outdated practices were reported in relation to some obstetric complications and newborn care. Encouraging results were reported with regard to positive relationships that traditional birth attendants have with their local health facilities. Furthermore, high rates of referral to health facilities was reported for many common obstetric emergencies and similar rates for reporting of pregnancy outcomes to village elders and chiefs.ConclusionsPotentially harmful or outdated practices with regard to maternal and newborn care among traditional birth attendants in western Kenya were revealed by this study. There were high rates of traditional birth attendant referrals of pregnant mothers with obstetric complications to health facilities. Policy makers may consider re-educating and re-defining the roles and responsibilities of traditional birth attendants in maternal and neonatal health care based on the findings of this survey.Electronic supplementary materialThe online version of this article (doi:10.1186/s12884-016-1007-8) contains supplementary material, which is available to authorized users.
Highlights
The high rate of home deliveries conducted by unskilled birth attendants in resource-limited settings is an important global health issue because it is believed to be a significant contributing factor to maternal and newborn mortality
Traditional Birth Attendants (TBAs) have been a controversial and sometimes contentious issue in subSaharan Africa, with some countries instituting or debating a national ban on traditional birth attendant (TBA) activities [9, 10] In Kenya, the activities of TBAs have been discouraged by the Government for several years; women are encouraged to seek delivery in health facilities with the assistance of skilled birth attendants [11]
At the time the TBA practices survey was conducted, the Kenya Demographic and Health Survey (KDHS) of 2008–2009 indicated that nationally, 56 % of Kenyan births occurred at home, and 28 % of these were reported conducted by a TBA
Summary
The high rate of home deliveries conducted by unskilled birth attendants in resource-limited settings is an important global health issue because it is believed to be a significant contributing factor to maternal and newborn mortality. Given the large number of deliveries that are managed by unskilled or traditional birth attendants outside of health facilities, and the fact that there is on-going discussion regarding the role of traditional birth attendants in the maternal newborn health (MNH) service continuum, we sought to ascertain the practices of traditional birth attendants in our catchment area. In low- and middle-income countries, a large percentage of babies are born outside of health facilities Many of these births are attended by unskilled community-based birth attendants [1]. While the overall proportion of births attended by skilled health professionals in Kenya has risen in recent years, from 44 to 62 %, with a concomitant increase in the proportion of deliveries that occur in a health facility (43 to 62 %) [13, 14], the regional rate of health facility-based deliveries via a skilled birth attendant in former Western Province, where this study was conducted, are lower as compared to the national average (around 47 %) [14, 15]
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