Services In Rural Communities Research Articles

Preparing Future Special Education Faculty for Service in Rural Communities

In this program description, the authors explain how a doctoral-level embedded service-learning opportunity, part of Project PURPLE (Preparing Urban and Rural Personnel as Leaders in Education), a collaborative personnel preparation training program, taught future faculty to meet the needs of urban and rural schools in high-need settings. The collaboration between two large institutions in the same state offered scholars a unique opportunity to engage in teaching, research, and service across institutions. For the service-learning project, teams of cross-institution scholars partnered with consultants from a regional special education cooperative that provides technical assistance to a large rural geographical area. Eleven scholars completed seven diverse service projects, ranging from training education professionals to engaging caregivers. This description discusses these projects, along with the benefits to the scholars and the regional cooperative. It also explores implications for practice for future personnel preparation collaborations and possible avenues for future research.

Bridging the Gap: Reducing Health Inequities in Access to Preventive Health Care Services in Rural Communities in the Philippines.

We used an implementation science framework to investigate perceived health inequities in preventive health care initiatives in rural communities in the Philippines. We also identified health equity-focused quality improvement strategies. Three health care providers and 12 barangay clinic patients were interviewed. Patient interviews showed that social determinants of health, respect, and attitudes toward health care providers affected patient empowerment to engage in self-management for noncommunicable diseases (NCDs). Health care providers identified six challenges in managing NCDs: (a) inefficient work processes; (b) staffing shortages; (c) insufficient access to low-cost medications; (d) inadequate primary preventive health education from the schools; (e) health care not considered a priority; and (f) lack of local government support. Inadequate preventive health care and education intensify health access and resource inequities in rural communities in the Philippines. A multi-sectoral plan may improve rural health infrastructure and education toward improving health care access and decreasing care disparities.

Research on the Evolution Trend and Characteristics of Policy Tool Selection for Urban and Rural Community Services

Research on the Evolution Trend and Characteristics of Policy Tool Selection for Urban and Rural Community Services

Challenges and coping strategies for providing maternal health care services among health care professionals in rural health facilities in Wolaita Zone, Southern Ethiopia: a qualitative study

BackgroundMany factors can decrease job productivity and cause physical and psychological complications for health care professionals providing maternal care. Information on challenges and coping strategies among healthcare professionals providing maternal healthcare services in rural communities is crucial. However, there needs to be more studies, especially qualitative research, to explore challenges and coping strategies for providing maternal health care services in Ethiopia among health care professionals, particularly in the Wolaita zone.ObjectiveTo explore the challenges and coping strategies of professionals providing maternal health care in rural health facilities in Wolaita Zone, Southern Ethiopia, in 2023.MethodA phenomenological qualitative study design was applied from May 20 to June 20, 2023. The study was conducted in rural areas of the Wolaita Zone, southern Ethiopia. Healthcare professionals from rural areas were selected using purposive sampling, and in-depth interviews were conducted. A qualitative thematic analysis was employed to analyze the data. Field notes were read, recordings were listened to, and each participant’s interview was written word for word and analyzed using ATLAS.ti 7 software.ResultFive main themes emerged from the data analysis. These themes included inadequate funding from the government, societal barriers to health and access to health care, professionals’ personal life struggles, infrastructure related challenges and health system responsiveness, and coping strategies. Reporting to responsible bodies, teaching mothers about maternal health care services, and helping poor mothers from their pockets were listed among their coping strategies.ConclusionHealthcare professionals have a crucial role in supporting women in delivering babies safely. This study revealed that they are working under challenging conditions. So, if women’s lives matter, then this situation requires a call to action.

The environmental effects of traditional livestock

Traditional livestock farming refers to rudimentary family-type livestock farms, which are carried out in small stables or caves and with limited resources. Traditional livestock farming has existed since ancient times, when humans began to domesticate animals for their benefit. Throughout history, traditional livestock farming has been an important source of food, products and services for rural communities. Eta is mainly dedicated to the breeding and management of domesticated animals for production purposes. These animals may include cattle, sheep, pigs, goats, poultry, among others. Traditional livestock activities may vary by region and community needs, but generally include the production of meat, milk, eggs, wool, and other animal products. In traditional livestock farming, native breeds adapted to the climatic and geographical conditions of the region are usually raised. These breeds tend to be more resistant to diseases and adverse conditions (greater rusticity). Natural feeding: Animals in traditional livestock farming feed mainly on grass and natural forage, which provides them with a balanced diet rich in nutrients. This contributes to the quality of the meat and dairy products obtained from these animals

Do Agricultural stakeholder panels enhance post-harvest loss reduction? Evidence from Malawi

Post-harvest loss significantly affects food security in sub-Saharan Africa (SSA) and elsewhere across developing countries. Weak institutional factors like ineffective agricultural extension services in rural communities can exacerbate such problems among smallholder farmers in SSA and other developing countries. Therefore, international development policies have prioritized strengthening rural extension systems to enhance access to effective extension services and thereby enhance food security outcomes like ineffective agriculturalpost-harvest loss reduction among rural households. As such, the US-Agency for International Development supported the Strengthening Agricultural and Nutrition Extension program in Malawi from 2015 to 2021 to improve access to rural extension services by promoting Agricultural Stakeholder Panels (ASPs)—platforms designed to enhance farmer interaction with local extension agents in rural communities and thereby enhance improved access to quality extension services in rural areas. The ASP approach can reduce post-harvest losses for major crops, such as maize. However, rigorous analyses of the effects of ASPs on post-harvest loss reduction remain limited. To address this knowledge gap, we apply recursive bivariate probit regression to primary survey data from 2134 households in Malawi to estimate the effects of the ASP approach on post-harvest loss reduction in 2018. The results show that ASPs reduced post-harvest losses among households by 53%, and a crucial outcome that can improve household food security. The result demonstrates that policies that strengthen rural extension systems can contribute to the achievement of the Sustainable Development Goals on hunger and food security in rural Malawi and similar contexts.

Unraveling patient satisfaction, associated factors, and dissatisfaction reasons in the provision of health care services for rural communities in Bangladesh: A cross-sectional investigation

BackgroundAccess to high-quality healthcare is a fundamental right, but rural communities in Bangladesh face challenges in accessing such services. Patient satisfaction plays a crucial role in healthcare outcomes. Identifying factors influencing satisfaction is vital for targeted interventions. MethodsA cross-sectional investigation was conducted in rural areas of Sirajganj, Rajshahi, Bangladesh, from April to June 2023. Convenient sampling was employed, and face-to-face interviews were conducted using a semi-structured questionnaire. A total of 411 participants were included in the final analysis. Descriptive statistics, as well as bivariate and multivariable logistic regression analyses, were carried out using SPSS software. ResultsMost unmarried participants (mean age: 41.93 ± 14.54 years; age range: 18–88 years) had primary education and a family income below 15,000 BDT. Among them, 80.3 % reported dissatisfaction with treatment. Significant factors linked to dissatisfaction included low education, being a businessman, living in nuclear families, daily physical exercise, difficulty accessing healthcare, average doctor-patient communication, high treatment costs, long waiting times, government hospital services, proximity to healthcare centers, lack of follow-up services, and absence of Telemedicine or M-health services. ConclusionThis study identifies key factors affecting patient satisfaction in rural Bangladesh. Interventions should focus on improving doctor-patient communication, reducing treatment costs and waiting times, enhancing access to healthcare and follow-up services, and incorporating Telemedicine or M-health services. Special attention is needed for businessmen, nuclear family residents, those who exercise daily, and patients using government hospitals or living near healthcare centers, as these groups report higher dissatisfaction.

Barriers and Attitudes towards Mental Health Services in Nigeria: A Systematic Review

Mental health services in Nigeria consists mainly of large government psychiatric hospitals. There are eight Neuropsychiatric hospitals and a similar number of teaching hospital psychiatric departments for a population of 200 million people. There is only one private community residential facility available with ten beds in Lagos State and it is administered by a religious organization for rehabilitation of persons with drug problems.In Nigeria, an estimated 20-30%of the population are believed to suffer from mental disorders.MEDLINE EntrezPubmed search was done in November, 2018. Studies conducted on mental health and mental health services in Nigeria done from 2009 till date were selected for review. The studies were grouped into two categories according to the key words used in the search. Category 1: Keywords used in the search: mental health,Nigeria.This search yielded a total of one thousand and fifty (1,051) publications. Category 2: Keywords used in the search: mental health services,Nigeria. Lack of incentives for health care workers and inadequate workforce were identified as some of the barriers against the use of mental health services in Nigeria. Other major barriers identified were- poor education, ignorance, and stigmatization. Absence of services in rural communities, waiting time at the facilities, bureaucracy in treatment and poor information management, high cost of service, travel distance, feelings of shame and loss of productive income were the barriers identified in some other studies conducted in Nigeria.

Is volumetric pricing for drinking water an effective revenue strategy in rural Mali?

Africa lags behind the world on operational and financial progress to maintain safe drinking water services. In rural Mali, we explore the implications of monthly flat fee contributions and volumetric (pay-as-you-fetch) payments for water use and revenue generation. By assessing 4413 months of data across 177 handpumps, we find that once payment modalities switch from volumetric payments to monthly flat fees, a waterpoint registers a more than three-times higher monthly revenue. While flat fees cover a higher share of the operational costs of providing reliable water services, a subsidy gap persists. Flat fees appear to stimulate daily water use which more than doubles compared to volumetric payments. We estimate that a 1 °C increase in average monthly temperature is associated with 180 more litres of water used every day per handpump, emphasising the importance of climate-resilient water supplies. Based on these insights, we discuss the role of professional service delivery models to support reliable drinking water services for rural communities.

Community First Responders' role in the current and future rural health and care workforce: a mixed-methods study.

Community First Responders are trained volunteers dispatched by ambulance services to potentially life-threatening emergencies such as cardiac arrest in the first vital minutes to provide care until highly skilled ambulance staff arrive. Community First Responder schemes were first introduced to support ambulance services in rural communities, where access to prehospital emergency care is more likely to be delayed. Evidence is lacking on their contribution to rural healthcare provision, how care is provided and how this might be improved. We aimed to describe Community First Responder activities, organisation, costs of provision and outcomes of care together with perceptions and views of patients, public, Community First Responders, ambulance service staff and commissioners of their current and future role including innovations in the rural health and care workforce. We used a mixed-methods design, using a lens of pragmatism and the 'actor', 'behaviour change' and 'causal pathway' framework to integrate quantitative routine and qualitative (policy, guideline and protocol documents with stakeholder interview) data from 6 of 10 English ambulance services. We identified potential innovations in Community First Responder provision and prioritised these using a modified nominal group technique. Patients and public were involved throughout the study. In 4.5 million incidents from six English regional ambulance services during 2019, pre COVID-19 pandemic, Community First Responders attended first a higher proportion of calls in rural areas (almost 4% of calls) than in urban areas (around 1.5%). They were significantly more likely to be called out to rural (vs. urban) areas and to attend older (vs. younger), white (vs. minority ethnic) people in more affluent (vs. deprived) areas with cardiorespiratory and neurological (vs. other emergency) conditions for higher-priority emergency or urgent (category 1 and 2 compared with category 3, 4 or 5) calls but did also attend lower-category calls for conditions such as falls. We examined 10 documents from seven ambulance services. Ambulance policies and protocols integrated Community First Responders into ambulance service structures to achieve the safe and effective operation of volunteers. Costs, mainly for training, equipment and support, varied widely but were not always clearly delineated. Community First Responders enabled a faster prehospital response time. There was no clear benefit in out-of-hospital cardiac arrest outcomes. A specific Community First Responder falls response reduced ambulance attendances and was potentially cost saving. We conducted semistructured interviews with 47 different stakeholders engaged in Community First Responder functions. This showed the trajectory of becoming a Community First Responder, the Community First Responder role, governance and practice, and the positive views of Community First Responders from stakeholders despite public lack of understanding of their role. Community First Responders' scope of practice varied between ambulance services and had developed into new areas. Innovations prioritised at the consensus workshop were changes in processes and structures and an expanded scope of practice supported by training, which included counselling, peer support, better communication with the control room, navigation and communication technology, and specific mandatory and standardised training for Community First Responders. Missing data and small numbers of interviews in some stakeholder groups (patients, commissioners) are sources of bias. Future research should include a robust evaluation of innovations involving Community First Responders. This trial is registered as ClinicalTrials.gov, NCT04279262. This award was funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme (NIHR award ref: NIHR127920) and is published in full in Health and Social Care Delivery Research; Vol. 12, No. 18. See the NIHR Funding and Awards website for further award information.

From market-based development to value chain transformation: What markets can (not) do for rural poverty alleviation?

Market reforms are considered as an important strategy to support poverty reduction amongst small-scale agrifood producers in developing and emerging economies. Most attention is commonly focused on voluntary initiatives that provide a guaranteed minimum price to farmers and improve services for rural communities, supplemented by good agricultural practices for higher productivity, environmental quality and to support living incomes. Whereas alternative trade movements have become ‘mainstream’ their market shares are stagnating. Since agrifood markets have changed substantially and trade networks are restructured, smallholders are increasingly controlled by midstream agents (traders and processors) and captured into contract farming arrangements. This article outlines a new discourse around value chain transformation that supports local processing for income and employment generation and favours better integrated supply chains based on circularity and trust. It identifies new alliances between producers and traders that change market governance beyond simple adjustments in exchange relationships. Combining public investments (market infrastructure) with civic-driven organization (cooperation and contracts) and private networks (for profit redistribution along the value chain) offers interesting opportunities for linking sustainable business practices with value-driven trade arrangements.

An empirical study on social network analysis for small residential communities in Gangwon State, South Korea

Social Network Analysis (SNA) provides a dynamic framework for examining interactions and connections within networks, elucidating how these relationships impact behaviors and outcomes. This study targeted small residential communities in Gangwon State, South Korea, to explore network formation theories and derive strategies for enhancing health promotion services in rural communities. Conducted in 12 small residential areas, the survey led to a network categorization model distinguishing networks as formal, informal, or non-existent. Key findings demonstrated that demographic and socio-economic factors, specifically age, income, living environment, leisure activities, and education level, significantly influence network formation. Importantly, age, environmental conditions, satisfaction with public transportation, and walking frequency were closely associated with the evolution of formal networks. These results highlight the importance of early community network assessments, which must consider distinct network traits to develop effective health promotion models. Utilizing SNA early in the assessment process can improve understanding of network dynamics and optimize the effectiveness of health interventions.

The Impact of Telerehabilitation on Physical Therapy Services in Rural Communities

Telerehabilitation is a transformative approach to physical therapy, revolutionizing the accessibility of healthcare in rural communities through the strategic use of Telecommunications technology. This novel approach has the potential to significantly enhance the efficacy of healthcare delivery, particularly considering the critical challenges posed by geographical isolation and resource scarcity. This paper explores the multifaceted benefits of Telerehabilitation, including increased access to care and reduced costs, alongside the challenges of technological barriers and privacy considerations. It provides a comprehensive overview of Telerehabilitation’s impact on rural healthcare, emphasizing its capacity to optimize patient outcomes and proposing strategies for effective implementation. The findings of this study suggest that the use of technology to deliver telecare is a key means of delivering equitable healthcare to underserved populations, a promising way to improve access to rural physiotherapy services address the challenge of telehealth resources, and promote the long-term sustainability of rural Telerehabilitation practices.

Maternal and child health care access to skilled delivery services among Ghanaian rural mothers

IntroductionMost new-born babies are born at home in rural communities which is not new phenomenon due to lack of access to primary healthcare services and trained skilled health attendants, exposing mothers and children to a high risk of labour complications. The purpose of this study was to better understand factors influence rural women's access to primary health care and skilled delivery services as well as their reasons for using or not using maternal health care and skilled delivery services.MethodsThe study employed a social survey design with a quantitative approach to data analysis. Cluster Sampling was used, possibly based on rural communities, to efficiently collect data from different geographic locations. Simple random sampling individuals from each cluster ensures that all eligible individuals have an equal chance of being included in the study. This enhances the representativity of the sample. A total of 366 mothers were selected from four rural communities in the North East Region of Ghana. The choice of sample size considered factors like the study's objectives, available resources, and the desired level of statistical power. Data was primarily gathered through the administration of a questionnaire to the respondents. Factors considered for achieving representativity include, geographic representation, accessibility, healthcare infrastructure and healthcare professionals’ attitudes.FindingsThe study found that distance to health centres limits women's access to skilled delivery services. Lack of primary health facilities in the rural communities hamper maternal and child care services delivery. The attitude of health care professionals determines a mother’s utilisation of maternal health care and skilled delivery services.ConclusionThe study contributes to the limited research on maternal health services and their impact on mother and child health in the study area. This study is one of the first to investigate into maternal health care as a key predictor of mother and child health in the study area. The study's theoretical lens was the Andersen and Newman Health Behavioural Model theory, which supports the explanation of distance, lack of primary health centres, attitudes and lack of skilled personnel to the non-utilisation of maternal and health services in rural communities. The study recommended that primary healthcare facilities and trained health professionals should be a priority of government in rural communities to promote maternal and child healthcare.

Consensus Guidelines for Assessment and Comprehensive Outcomes Evaluation in Rural Pain Clinics

Recent advancements in nurse anesthesiology fellowship training programs have helped to establish advanced pain management services for rural communities. Consensus guidelines to direct the rural provider toward the most valid and reliable measures for pain assessment and functional outcomes evaluation are not presently available. The primary aim of this initiative was to establish consensus guidelines for a comprehensive outcome evaluation program with specific time intervals for assessments that can be utilized by all rural pain clinics. The American Association of Nurse Anesthesiology Nonsurgical Pain Management Advisory Panel members provided formative and expert feedback for this initiative. The Delphi model was utilized to achieve consensus through multiple rounds of surveys. Items achieving >70% agree/strongly agree were kept; items with >70% disagree/strongly disagree were rejected; items meeting neither advanced to the following round for evaluation until consensus was met. During round I, consensus was reached for: (1) the use of the Numerical Rating Scale for pain severity; and (2) timing of pain severity & functional pain outcomes on each office visit and before/after each intervention. Round II, consensus was achieved for: (1) the use of Wong-Baker FACES Pain Rating Scale as a suitable instrument when literacy or communication pose a barrier but not as a primary assessment; and (2) the use of the Brief Pain Index-Short Form for functional outcome measures. During round III, consensus was reached for: (1) the use of the Oswestry Disability Index as a functional outcome measure; and (2) pain reassessment being performed within 14 days of intervention. This initiative provides rural pain clinics with a comprehensive outcome evaluation program with specific time intervals for assessments.

Prospects and challenges of agricultural financing in Nigeria: A review

This paper examined the prospects and challenges of agricultural financing in Nigeria. It was observed that agricultural financing is all about providing services to the farmers who are traditionally not served by the conventional financial institutions. Agricultural financing holds a lot of prospects for Nigerians especially the poor as it will enable them develop their skills, engage in production and many others. Among the problems identified are access to banking services in rural communities, lack of acceptable collateral/ security, perceived high agricultural risk, lack of access to credit information, high cost of credit administration, access to market, infrastructural challenges and subsistence nature of farming. The various prospects highlighted include; economic empowerment of farmers, poverty reduction, gains from international trade, employment generations, rural development, skill development, new innovations, effective utilization of local resources and output expansion. Consequent upon the problems noted, the paper recommends that the supervisory authorities should enforce standards so as to address the issue of poor management of funds meant for credit disbursement.

The acceptance of traditional Chinese medicine among patients with Parkinson’s disease: A hospital survey

ObjectiveThe efficacy of medications for Parkinson’s disease (PD) tend to decline over time, which has a serious impact on patients’ health and quality of life. To some extent, traditional Chinese medicine (TCM) can resolve the distressing problem of ineffective dopaminergic medication in PD patients. The purpose of this study was to investigate the attitude, acceptance, and independent predictors of TCM in PD patients admitted to the outpatient department of a tertiary hospital. MethodsA cross-sectional study of PD patients was conducted in the outpatient department of a large tertiary hospital in Beijing from March 2022 to June 2023. A self-report questionnaire was developed to investigate PD patients’ attitudes and acceptance of TCM based on the questionnaire. Multivariate logistic regression analyses were also performed to further clarify the independent predictors influencing patients’ adoption of TCM therapy. ResultsA total of 397 patients completed the questionnaire, of which 78.09% were willing to be treated with TCM and 21.91% indicated that they were not willing to use TCM. Multifactorial logistic regression analysis showed that several parameters were correlated with a patient’s willingness to include TCM in their therapeutic regime. These included education level of a bachelor’s degree (odds ratio [OR) = 8.554; 95% confidence interval [CI]: 4.112–17.794; P < 0.001, vs junior high school education), living in an urban setting (OR = 8.022; 95% CI: 4.577–14.060; P < 0.001, vs rural), having other underlying diseases (OR = 5.126; 95% CI: 3.078–8.537; P < 0.001, vs none), having previously used TCM (OR = 3.083; 95% CI: 1.852–5.134; P < 0.001, vs not used), believing that TCM therapy is safe (OR = 3.530; 95% CI: 1.446–8.616; P = 0.006, vs not thought), believing that TCM therapy is effective (OR = 3.859; 95% CI: 1.482–10.047; P = 0.006, vs not understood), and being willing to discuss ongoing TCM therapy with an attending physician (OR = 62.468; 95% CI: 30.350–128.574; P < 0.001, vs not informed). ConclusionThis study initially investigated the acceptance, attitude, and independent predictors of TCM use among PD patients. To expand the prevalence of TCM use among patients with PD, we recommend to broadening the public outreach for TCM via contemporary means of Internet and broadcast communication, enhancing access to TCM services in rural communities, and strengthening the communication between doctors and patients.Please cite this article as: Wang P, Hong J, Tang ZQ, Gong BZ, Qi XR, Jiang H, Pan B, Chen Q. The acceptance of traditional Chinese medicine among patients with Parkinson’s disease: A hospital survey. J Integr Med. 2024; 22(2): 180–187.

Saving Hearts in Rural West Texas: The Impact of Critical Care Access on Mortality Rates.

Background The Critical Access Hospital (CAH) designation program was created in 1997 by the US Congress to reduce the financial vulnerability of rural hospitals and improve access to healthcare by keeping fundamental services in rural communities. Methods This is a retrospective observational study. Information on CAHs in West Texas in rural counties was extrapolated from the Flex Monitoring Team between 2010 and 2020. The study population included adults aged ≥25 years with a known heart failure (HF) diagnosis who were identified using ICD-10 codes. Mortality rates were obtained from the CDC Wide-ranging ONline Data for Epidemiologic Research (WONDER) database. The HF population was categorized by age, sex, and ethnicity. Mortality differences among these groups were analyzed using a two-sample t-test. The significance level was considered to be p < 0.05. Results The total study population analyzed was 1,348,001. A statistically significant difference in age-adjusted mortality rate (AAMR) was observed between the study and control groups, with a value of 3.200 (95% CI: 3.1910-3.2090, p < 0.0001) in favor of a lower mortality rate in rural counties with CAHs. When comparing gender-related differences, males and females had lower AAMRs in rural counties with CAHs. Among each gender, statistically significant differences were noted between males (95% CI: 2.181-2.218, p < 0.001) and females (95% CI: 3.382-3.417, p < 0.001). When examining the data by ethnicity, the most significant difference in mortality rate was observed within the Hispanic population, 6.400 (95% CI: 6.3770-6.4230, p < 0.0001). When adjusted to age, the crude mortality rate was calculated, which favored CAH admission in the younger population (10.200 (95% CI: 10.1625-10.2375, p < 0.001) and 11.500 (95% CI: 11.4168-11.5832, p < 0.001) in the 55-64 and 65-74 age groups, respectively). Conclusion The data clearly showed that West Texas rural county hospitals that received CAH designation performed better in terms of mortality rates in the HF population compared to non-CAH.

A Rational Review of Building a High Quality Urban and Rural Community Service System

Community service not only affects the quality of life and happiness index of the people, but also reflects the warmth and effectiveness of the community. The construction of community service system is an important path for innovation in community governance system. As China enters a stage of high-quality development, facing problems such as imbalanced and insufficient development of urban and rural community services, incomplete multi-party participation pattern, and weak information infrastructure construction, the construction of urban and rural community service system must focus on improving the pattern of urban and rural community services, enhancing the supply of urban and rural community services, and improving the efficiency of urban and rural community services, Under the new requirements of improving people's quality of life, three major breakthroughs have been achieved in terms of concept, function, and logic: the service concept has shifted from "product supply" to "demand satisfaction", the service function has shifted from "bottom line guarantee" to "quality of life", and the service logic has shifted from "government catering" to "ordering from a hundred surnames".

Knowledge and attitudes of midwives towards collaboration with traditional birth attendants for maternal and neonatal healthcare services in rural communities in South Africa

ObjectivesWe assessed the knowledge and attitude of registered midwives towards collaborating with traditional birth attendants for maternal and neonatal healthcare services in rural communities. DesignA descriptive cross-sectional survey was followed in this study. ParticipantsRegistered midwives in selected clinics in the City of Tshwane Municipality. Participants were recruited by stratified random sampling. Data was collected at the Thirty-four primary healthcare facilities in Gauteng province, South Africa. Measurement and resultsA self-assessment questionnaire was administered to 304 registered midwives. Two-hundred and sixty respondents returned the questionnaire representing a response rate of 86.6 % which was statistically significant. The majority of Midwives in South Africa displayed a low level of knowledge (mean = 41.8, SD=1.7) on the role and practices of traditional birth attendants). Only 30.8 % (n = 80) of midwives knew of the roles of traditional birth attendants for maternal and neonatal healthcare (MNH) services. With respect to knowledge, there was significant associated with the Professional category (p < 0.015). In terms of attitude, registered midwives displayed negative attitudes towards collaborating with traditional birth attendants (mean = 46.8, SD=2.1). Approximately half (54.2 %, n = 140) of midwives were amenable towards collaborating in the provision of antenatal care, and 70.4 % (n = 183) of midwives agreed to collaborate with traditional birth attendants for extended roles such as accompanying women to health facilities. Association of demographic data and level of attitude showed there was significant relationship (p < 0.05) between registered midwives’ level of education and their attitude towards collaboration. Key conclusionsMidwives demonstrated positive attitude towards collaborating with traditional birth attendants at the antenatal care level only. Midwives were not amenable to collaboration at the level of intrapartum and postpartum care. Implications for practiceBased on our results, collaboration should be at antenatal care level to allow for early detection, treatment, and prevention of antenatal complications thus reducing maternal mortality and morbidity.