Knowledge Of Traditional Birth Attendants Research Articles

Knowledge Contestation of Midwives and TBAS: Study of Patterns of Domination, Hybridization, and Coexistence in Childbirth

Purpose: This study aims to analyze the contestation between the medical knowledge of midwives and the local knowledge of traditional birth attendants in accompanying pregnant women to delivery in the Gowa Regency. We also investigate the contestation between the medical knowledge of midwives and the local knowledge of traditional birth attendants in postnatal and infant care. Method: The research method uses a qualitative approach with case studies and data collection through interviews, observation, and documentation. Results and conclusion: The results identified three patterns of knowledge contestation between midwives and shaman uncles, namely domination, hybridization, and coexistence. Domination occurs in the context of pregnancy, where the knowledge of the shaman Pamana dominates the midwife, while hybridization occurs during the delivery process with collaboration between the midwife and the shaman Pamana. The pattern of coexistence illustrates that the knowledge of midwives and shaman Pamana is present together without interfering with each other in postnatal care. Research implications: This research is relevant to the maternal and newborn health system in Gowa Regency with the following implications: 1) Integration of medical and local knowledge is needed in the practice of midwives and birth attendants, emphasizing the need for holistic training for health service providers; 2) Collaboration between midwives and traditional birth attendants can improve the safety of mothers and babies; 3) Cultural awareness is important to improve quality of care; 4) Culturally sensitive practice guidelines are necessary for safe and effective practice; 5) Public advocacy and education can increase awareness of appropriate care. Originality/value: This research reveals the dynamics of contestation between medical and local knowledge in maternal and neonatal health services, providing new insights into their interactions. These findings support the development of more effective interventions, contribute to the reproductive health literature, and provide insights for more inclusive policies.

HEALTH CARE PROVIDERS’ VIEWS CONCERNING KNOWLEDGE AND PRACTICES OF TRADITIONAL BIRTH ATTENDANTS IN TAJIKISTAN: A QUALITATIVE STUDY

Introduction: This study seeks to explore health care providers’ perspectives of the traditional birth attendants’ knowledge and practices. Methods: This qualitative study was conducted in 2018 with 16 health care professionals working at various levels of maternal health care system in two purposefully selected research settings, Khorog town and Dushanbe, which have different social, economic and ethnic backgrounds. Semi-structured face-to-face interviews were conducted to gather the data. Duration of interviews ranged from 30-60 min. NVivo software for qualitative research was used to analyse the results. Results: This study has shown that health care workers have extremely negative views of the knowledge and practices of traditional birth attendants. They highlight the lack of adequate knowledge of traditional birth attendants on biomedical aspects of birth, poor skills in infections control and lack of use of clean delivery practices. They also claim that the traditional birth attendants’ practices also lead to different complications while they are woefully unprepared to recognize obstetric complications during birth. Conclusion: The study recommends providing a skilled birth attendant in every area. It also recommends avoiding a homogeneous approach to address maternal health issues in diverse countries of the Global South and reviewing maternal health care policies and programs to provide the most marginalized groups of women with skilled birth services to improve their maternal health and further decrease maternal mortality in Tajikistan.

Enhancing Knowledge of Traditional Birth Attendants for the Identification of Selected Labor Emergencies

Objectives: In Nigeria, the number of professional midwives available for care of pregnant women and their babies is inadequate; hence, most pregnant women are attended to by Traditional Birth Attendants (TBAs). Studies show that TBAs have poor knowledge of how to identify obstetrics complications. Aim: To determine the effectiveness of a training program on enhancing the knowledge of TBAs in the identification of some selected labor emergencies. Materials and Methods: An experimental research design was conducted with probability sampling to select sample size (n = 111 TBAs). A modified, structured questionnaire from TBAs knowledge on identification of labor emergencies (TBAs-TPKI) was used for data collection. Data collected were analyzed using Statistical Packages for the Social Science (SPSS) software. Descriptive statistics were used to provide answers to the six research questions of the study while inferential statistics of paired t-test was used to test the hypothesis of the study at 0.05 level of significance. Results: The results show that the mean score on knowledge identification on prolonged labor increased from 4.88±2.54 to 11.56±1.48; obstructed labor from 4.18±2.18 to 5.73±1.26, cord presentation from 2.44 ±1.27 to 5.78 ± 0.74, cord prolapse from 2.79±1.45 to 6.60±0.84, placenta abruptio from3.83±1.99 to 9.08±1.16 and postpartum hemorrhage from 3.48±1.82 to 8.26±1.05. The overall mean score of TBAs on knowledge of identification increased from 21.59 ± 11.26 to 51.19 ± 6.54 post-intervention. There was a significant difference between pre- and post-intervention mean scores of knowledge of TBAs on the identification of all the selected labor emergencies (t = 32.208, p = 0.00). Conclusions: The Ministry of Health in each state should organize regular training for TBAs to target early identification of obstetrics emergencies in order to reduce maternal mortality in Nigeria.

Infection prevention and control practice among traditional birth attendants in Lagos State, Nigeria

Background The World Health Organization has defined a traditional birth attendant as a ‘person who assists the mother during childbirth and initially acquired her skills by delivering babies herself or through apprenticeship to other traditional birth attendants’. It is estimated that over 40 million neonatal deaths occur annually worldwide; some of these deaths are the result of infection, which may be attributed to the practices of traditional birth attendants. In Nigeria, maternal mortality because of puerperal sepsis occurs in 12% of cases. This study aimed to assess infection prevention and control practice among traditional birth attendants in Lagos State, Nigeria. Methods This is a descriptive study of infection prevention and control among traditional birth attendants in the three local government areas of Ikorordu, Mushin and Surulere. Simple random sampling (balloting) was used to select 144 registered traditional birth attendants. A self-structured questionnaire made up of four sections (sociodemographic characteristics, knowledge, attitude and practice) was used for data collection. The participant knowledge scores were categorised into ‘good’ (60–100%) and ‘poor’ (0–59%). Descriptive and inferential statistics were used to analyse the data and tested for significance at P=0.005. Results The mean age of the respondents was 48 ± 10.6 years. Over one-third (37.5%) of the respondents had poor knowledge of infection control. There was a statistically significant association between respondent age and practice of infection prevention and control (P=0.003). There was no significant difference between the duration of practice and infection prevention and control (P=0.688). Additionally, there was no significant association between the length of training and infection prevention and control (P=0.890). Conclusions There is a need to increase the knowledge of traditional birth attendants by organising training for them on infection prevention and control. Over 70% of the respondents identified that practice could be improved by additional training. This will reduce maternal and infant morbidity and mortality caused by infection in Lagos, Nigeria.

Knowledge Towards Immunizations among Traditional Birth Attendants in Wassit Governorate

Objective:  This study aimed to assess the knowledge of traditional birth attendants regarding Immunization.                                                                                                                Methodology: This study  was a cross sectional study conducted at wassit government , for a period of 4 months  extending  from  1st of  March  2015  to the 1St  June 2015. The study sample included 64 traditional birth attendants whose ages were 21 years and above. Data collection was obtained by direct interview ( using the questionnaire form) . The Research objectives are explained to TBAs and an emphasis on the confidentiality of information.     Results:  forty-sixty  (64) TBAs were included in this study, Significantly over 75% (48) found in age >40 years.  21  (32.81%)  had read and write level . They were predominantly married,  67.19  %. In addition, They were residing in an urban area. Relative to length of experience, the highest frequency of TBAs were in the length of experience of  TBAs (15 < ) years was 53.13 %. nearly half of them (57.81%) were trained in the sectors of health. High  knowledge towards Immunizations was observed among (93.75 %) of TBAs Recommendations: Depending on the high rate of TBAs’ knowledge concerning  Immunization recommend to train TBAs and utilize of them in the provision of advice on Immunization, especially in rural areas. Consolidation of relations between TBAs and health sectors, because of the significant impact on the high level of disease prevention, through seminars, lectures and open meetings.                                                                                                  &nbsp

Handling postpartum haemorrhage- obstetrics between tradition and modernity in post-war Sierra Leone.

How traditional birth attendants (TBAs) in post-war Sierra Leone explain, handle and prevent postpartum haemorrhage (PPH) and their potential role in a better management of PPH to reduce maternal mortality in this low resource setting. Semi-quantitative interviews about knowledge and measures in PPH and participant observation with 140 Sierra Leonean birth attendants, divided in three groups: (A) TBAs who never attended any official training course (n = 82); (B) TBAs who attended at least one official training course (n = 48); and (C) officially trained birth attendants (n = 10). There are several observable gaps in the knowledge of TBAs about PPH compared to modern obstetrics, however similar procedures exist. Herbal medicine is applied; metaphysical convictions about PPH remain present. Training courses show an impact. Officially trained birth attendants demonstrate knowledge deficiencies and lack resources and infrastructure to manage PPH adequately. Morbidity and mortality of PPH in Sierra Leone is related to several factors and not solely to the ignorance of TBAs. TBAs still play an important role for many women there. Hence improvement of the formal health sector should be combined with life-saving programmes integrating TBAs in the care for the pregnant, delivering and breastfeeding mothers.

English

According to the World Health Organization (WHO), current estimate of maternal mortality ratios is at more than 1000 per 100,000 live births in most African countries. Despite the existence of modern health facilities in Nigeria, over 58% of deliveries take place at home whereas only 37% take place in hospitals. As outcomes of pregnancy and their sequelae are purely left to the providence of women in many rural communities, the place of delivery is a great determinant of maternal and child morbidity and mortality. With the shortage of skilled birth attendants and uneven geographical distribution of the few available ones; traditional birth attendants tend to fill in the gap. This study employed a cross sectional design and using a simple random sampling technique, 420 women within the reproductive age (18 - 45 years) meeting the inclusion criteria for the study were selected. Results from the study indicated a high (88.8%) knowledge of Traditional Birth Attendants (TBAs) but a poor (51.1%) perception about their practices. A significant relationship was shown between age (P<0.05), education status (P<0.05) and the frequency of patronage of TBAs Services. Although, perception about TBAs practices was poor, the role of TBAs in the improvement of women’s health (maternal and child health) in rural Nigeria cannot be ignored. TBAs remain major health resources in rural communities in developing countries as well as some parts of urban areas. Efforts need to be harnessed for training of TBAs through the Ministry of Health and Primary Health Care facilities close to their area of practices. Key words: Knowledge, perception, traditional birth attendants, maternal mortality, Southern Nigeria.

Indigenous beliefs and practices that influence the delayed attendance of antenatal clinics by women in the Bohlabelo district in Limpopo, South Africa

Objective to explore and describe the indigenous beliefs and practices that influence the attendance of antenatal clinics by women in the Bohlabelo district in Limpopo, South Africa Research design and methods a qualitative design was used to enable participants to share their beliefs and practices in their own words. Purposive sampling was used. Setting women who were attending antenatal clinics for the first time were targeted. Data were collected via unstructured in-depth interviews. Twelve women were interviewed. Findings the findings were grouped into six main categories: pregnancy is a honour; pregnancy needs to be preserved; the unborn infant is protected; the knowledge that clients have; trust in indigenous perinatal practices; and perceptions regarding clinic or hospital services. It became clear that the indigenous beliefs and practices of pregnant women have an influence on their attendance of antenatal clinics. For example, factors such as fear of bewitchment cause delayed attendance of antenatal clinics. Women use herbs to preserve and protect their unborn infants from harm. They also trust the knowledge of traditional birth attendants, and prefer their care and expertise to the harsh treatment that they receive from midwives in hospitals and clinics who look down on their indigenous beliefs and practices. Conclusions it is recommended that indigenous beliefs and practices should be incorporated into the midwifery curriculum, so that the health sector is able to meet the needs of all members of the community.

Do Health Worker Female and Traditional Birth Attendant Equipped to Provide Primary Health Care in Tribal Areas? Evidences from Tribal Andhra Pradesh

An attempt has been made in this paper to study the knowledge skills and performance of Multi purpose Health Worker (Female) (MPHW-F) working in tribal areas of Andhra Pradesh their self perceived training needs in various areas of Maternal and Child Health and the knowledge of Traditional Birth Attendants in providing maternal and child health services in tribal areas. The study found that in general the MPHW (F) were ill equipped to provide MCH services in tribal areas. The knowledge of health worker female in areas of MCH were very poor especially in areas of intra natal post natal and treatment of minor ailments. The skills were also far below satisfactory. Majority of them could not perform accurately even the basic skills like taking height and weight of pregnant women. The other skills like hoemoglobin testing urine testing for albumin etc were performed by gross error. Health worker over estimated their level of knowledge and skills and under estimated their need for training. The TBAs too were lagging behind in the correct knowledge and safe practices in conducting delivery. Hence there is an urgent need to redesign the basic training of health workers working in tribal areas. (authors)