Traditional and Skilled Birth Attendants in Zimbabwe: A Situational Analysis and Some Policy Considerations

Naume Zorodzai Choguya

doi:10.1155/2015/215909

Abstract

The paper focuses on the situational analysis of traditional birth attendants (TBAs) and skilled birth attendants (SBAs) in Zimbabwe. Against a background of a frail health care system, characterised by a shortage in skilled professionals, increased cost of medical care, and geographic and economic inaccessibility of health care centres among others, TBAs have remained a life-line for especially many rural women in maternal health care provision. Moreover, TBAs have also found their way into the urban areas of Zimbabwe. The shift in international policy and health funding toward skilled birth attendants (i.e., an accredited health professional) has materialized into concerted government efforts to increase numbers of both midwifery training institutions and midwives themselves. The call for SBAs, though a worthy ideal, is out of touch with the lived realities of pregnant women in low resource settings such as Zimbabwe. The study is concerned with situational analysis of TBAs and SBAs in maternal health care service provision in Zimbabwe analysing and evaluating policy considerations.

Highlights

This paper is based on desk research which entailed extensive sourcing and reading of literature related to maternal health issues in Zimbabwe
Many countries often have a shortage of trained medical professionals and maternal health care is provided by Traditional Births Attendants (TBAs) [2, 3]
The Cochrane Review [45] concluded that “after more than three decades of experience, the evidence to support TBA training has been limited and conflicting.”. This shift in policy towards skilled birth attendants (SBAs) has had the effect of marginalizing TBA practice in maternal health care provision in Zimbabwe

Summary

Introduction

This paper is based on desk research which entailed extensive sourcing and reading of literature related to maternal health issues in Zimbabwe. The WHO [12] posits that skilled birth attendance during delivery is a key strategy in the reduction of maternal deaths and defines a skilled attendant as an accredited health professional—such as a midwife, doctor, or nurse—who has been educated and trained to be proficient in the skills needed to manage normal (uncomplicated) pregnancies, childbirth, and the immediate postnatal period and in the identification, management, and referral of complications in women and newborns [13]. According to a report by a government official, skilled attendance at delivery had declined to 68% in the last decade and home deliveries were at about 28% One reason for this is the exodus of trained midwives from the formal health care services. It is hoped that the health sector will begin to recover after a decade-long decline

A Situational Analysis of the Zimbabwean Context

Paradigm Shift to Skilled Birth Attendants

The Future of Maternal Health in Zimbabwe

Conclusion

Findings

Zimbabwe