Traditional Birth Attendants Research Articles

Building referral mechanisms for neonatal care in humanitarian emergency settings: A systematic review.

During humanitarian emergencies, women and children are particularly vulnerable to health complications and neonatal mortality rates have been shown to rise. Additionally, health cluster partners face challenges in coordinating referrals, both between communities and camps to health facilities and across different levels of health facilities. The purpose of this review was to identify the primary referral needs of neonates during humanitarian emergencies, current gaps and barriers, and effective mechanisms for overcoming these barriers. A systematic review was performed using four electronic databases (CINAHL, EMBASE, Medline, and Scopus) between June and August 2019 (PROSPERO registration number CRD42019127705). Title, abstract, and full text screening were conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. The target population was neonates born during humanitarian emergencies. Studies from high-income countries and prior to 1991 were excluded. The STROBE checklist was used to assess for risk of bias. A total of 11 articles were included in the analysis; these were mainly cross-sectional, field-based studies. The primary needs identified were referrals from homes to health facilities before and during labour, and inter-facility referrals after labour to more specialised services. Some of the main barriers included a lack of roads and infrastructure for transport, staff shortages-especially among more specialised services, and a lack of knowledge among patients for self-referral. Mechanisms for addressing these needs and gaps included providing training for community healthcare workers (CHWs) or traditional birth attendants to identify and address antenatal and post-natal complications; education programmes for pregnant women during the antenatal period; and establishing ambulance services in partnership with local Non-Governmental Organizations. This review benefited from a strong consensus among selected studies but was limited in the quality of data and types of data that were reported. Based on the above findings, the following recommendations were compiled: Focus on local capacity-building programmes to address programmes acutely. Recruit CHWs to raise awareness of neonatal complications among pregnant women. Upskill CHWs to provide timely, appropriate and quality care during humanitarian emergencies.

Hubungan Pengetahuan, Peran Keluarga Dan Kepemilikan Jaminan Kesehatan Dengan Pemilihan Penolong Persalinan Pada Ibu Hamil Di Desa Batuhideung Kecamatan Cimanggu Pandeglang Banten Tahun 2022

Introduction: The selection of birth attendants is one of the reproductive rights of individuals in determining where to give birth and who will assist in childbirth. Many factors influence the selection of birth attendants, including maternal knowledge, family roles, and BPJS card ownership. In the Cimanggu Health Center in 2021 48,7% of mothers were assisted by midwives, while 50,3% of mothers who gave birth were assisted by traditional birth attendants. The purpose of the study was to determine the relationship between knowledge, family roles, and health insurance ownership with the selection of birth attendants for pregnant women in Batuhideung Village, Cimanggu District, Pandeglang Banten in 2022. Methods: The research method used was quantitative analysis using a cross-sectional approach using primary data, the number of samples was as much as 52 third-trimester pregnant women, total sampling technique, data analysis using Chi-Square test. Result: The results of the univariate analysis revealed that the selection of birth attendants for pregnant women was mostly by health workers (midwives) 63,5%; with good knowledge of 55,8%; the role of the family supporting 71,2% and the ownership of BPJS Health was 65,4%. Based on the results of the chi-square test, there was a significant relationship between knowledge (p = 0,000); family roles (p = 0,011); and BPJS Health ownership (p = 0,000) with the selection of birth attendants for pregnant women. Discussion: The conclusion of the study there is a significant relationship between knowledge, family roles, and ownership of BPJS Health with the selection of birth attendants for pregnant women. It is hoped that mothers and families can provide mutual support in choosing delivery assistance assisted by health workers, besides having a BPJS card so that mothers and families feel calm during childbirth because they get cost waivers.

Maternal and newborn healthcare utilization in Kampala urban slums: perspectives of women, their spouses, and healthcare providers

BackgroundIt is assumed that the health conditions of urban women are superior to their rural counterparts. However, evidence from Asia and Africa, show that poor urban women and their families have worse access to antenatal care and facility childbirth compared to the rural women. The maternal, newborn, and child mortality rates as high as or higher than those in rural areas. In Uganda, maternal and newborn health data reflect similar trend. The aim of the study was to understand factors that influence use of maternal and newborn healthcare in two urban slums of Kampala, Uganda.MethodsA qualitative study was conducted in urban slums of Kampala, Uganda and conducted 60 in-depth interviews with women who had given birth in the 12 months prior to data collection and traditional birth attendants, 23 key informant interviews with healthcare providers, coordinator of emergency ambulances/emergency medical technicians and the Kampala Capital City Authority health team, and 15 focus group discussions with partners of women who gave birth 12 months prior to data collection and community leaders. Data were thematically coded and analyzed using NVivo version 10 software.ResultsThe main determinants that influenced access to and use of maternal and newborn health care in the slum communities included knowledge about when to seek care, decision-making power, financial ability, prior experience with the healthcare system, and the quality of care provided. Private facilities were perceived to be of higher quality, however women primarily sought care at public health facilities due to financial constraints. Reports of disrespectful treatment, neglect, and financial bribes by providers were common and linked to negative childbirth experiences. The lack of adequate infrastructure and basic medical equipment and medicine impacted patient experiences and provider ability to deliver quality care.ConclusionsDespite availability of healthcare, urban women and their families are burdened by the financial costs of health care. Disrespectful and abusive treatment at hands of healthcare providers is common translating to negative healthcare experiences for women. There is a need to invest in quality of care through financial assistance programs, infrastructure improvements, and higher standards of provider accountability are needed.

An Overview of the Knowledge and the Practice of Female Genital Mutilation Among Adult Women in Ondo State, South Western Nigeria

The practice of female genital mutilation (FGM) is one of the very significant health and human right issues in the world according to UNICEF. A qualitative research methodological and in-depth interview of one hundred and twenty informants were used to investigate FGM’s knowledge and practice in Ondo state, southwestern Nigeria. A multi-stage sampling technique was used to select the participants from the study population. The findings of the study revealed that the majority of the residents are aware of FGM as it is being widely practiced by traditional birth attendants, an health officials. The study also confirmed that the majority of the respondents are of the opinions that FGM reduces promiscuity, initiates young girls into womanhood; ensures spiritual cleansing; enhances fertility and prevents instant mortality while the majority have inadequate knowledge about the untoward health consequences of the practice. The study concluded that there is high rate of prevalence and poor understanding of the harmful effects of FGM. It is therefore recommended that certain collaborative measures which include aggressive enlightenment programmes. Among the communities, enactment of laws as punitive measures for the practitioners of government policy re-engineering and early education of girl’s children on FGM among others have to be implemented to eliminate the scourge in society.

A Qualitative Assessment of Community Acceptability and Its Determinants in the Implementation of Minimally Invasive Tissue Sampling in Children in Quelimane City, Mozambique.

The Countrywide Mortality Surveillance for Action project aims to implement a child mortality surveillance program through strengthening vital registration event reporting (pregnancy, birth, and death) and investigating causes of death (CODs) based on verbal autopsies. In Quelimane (central Mozambique), Minimally Invasive Tissue Sampling (MITS) procedures were added to fine-tune the COD approaches. Before the implementation of MITS, an evaluation of the acceptability and ethical considerations of child mortality surveillance was considered fundamental. A socio-anthropological study was conducted in Quelimane, using observations, informal conversations, semi-structured interviews, and focus group discussions with healthcare providers, nharrubes (traditional authorities who handle bodies before the funeral), community and religious leaders, and traditional birth attendants to understand the locally relevant potential facilitators and barriers to the acceptability of MITS. Audio materials were transcribed, systematically coded, and analyzed using NVIVO12®. The desire to know the COD, intention to discharge the elders from accusations of witchcraft, involvement of leaders in disseminating project information, and provision of transport for bodies back to the community constitute potential facilitators for the acceptability of MITS implementation. In contrast, poor community mobilization, disagreement with Islamic religious practices, and local traditional beliefs were identified as potential barriers. MITS was considered a positive innovation to determine the COD, although community members remain skeptical about the procedure due to tensions with religion and tradition. Therefore, the implementation of MITS in Quelimane should prioritize the involvement of a variety of influential community and religious leaders.

Research on natal and neonatal teeth in Africa: A systematic scoping review of empirical evidence.

In Africa, natal and neonatal teeth is a culture-bound phenomenon which is associated with several sociocultural connotations which might affect child survival. Different empirical studies have been conducted in Africa on natal and neonatal teeth; however, no known scoping review has been conducted to map the empirical evidence. This systematic scoping review (SSR) aims to document the available empirical evidence, research gaps, and hotspots on neonatal and natal teeth in Africa. The methodology of this SSR was informed by the Joanna Brigg's Institute guidelines for SSRs, and it was reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews. Eleven research databases were systematically searched to scooped out all literatures relevant to the scoping review question, after which they were screened for eligibility based on the review's selection criteria. Only the eligible literatures were included in the review. Data were extracted from the included literatures, after which the extracted data were collated, summarized, and presented as results. This review included only three journal articles. All the reviewed articles revealed knowledge gaps about natal/neonatal teeth. These articles also found misconceptions around natal/neonatal teeth; for example, nurses'and traditional birth attendants'beliefs about these teeth are contrary to scientifically known facts. Multiple myths associated with natal/neonatal teeth, as indicated in the reviewed studies, point to a poor understanding of the condition. Neonates and infants are highly vulnerable persons; they require care and safeguarding from dental myths that could threaten their survival. Educative information concerning natal/neonatal teeth should be included in public health education programs to address the observed knowledge gaps among African populations and correct wrong beliefs on neonatal and natal teeth.

Understanding birthing preferences of women in Benin City, Nigeria: a qualitative study

ObjectiveThe aim of this study was to explore women’s birthing preferences and the motivational and contextual factors that influence their preferences in Benin City, Nigeria, so as to better understand...

Traditional Health Care Practitioners' Perspectives on Applying Informed Consent During African Traditional Medical Practice in Akwa Ibom State, Nigeria: A Cross-Sectional Qualitative Study.

Introduction: This study explored the perspectives of traditional health care practitioners (THPs) practicing in the areas of herbalism, bone setting, and traditional birth attendance, from Akwa Ibom state, Nigeria, on the possibility and implications of applying informed consent (IC) during African traditional medicine (ATM) practice. Methods: Semistructured interviews were conducted with 11 THPs, consisting of 5 herbalists, 3 traditional bone setters (TBS), and 3 traditional birth attendants (TBAs), who represented the diverse groups that the study intended to cover. In-depth interviews were conducted using a semistructured guide and were recorded, transcribed, and analyzed using thematic analysis with the assistance of NVivo® qualitative analysis software. Results: Participants were seven males (64%) and four females (36%), 35-67 years of age, with 5-25 years of experience as THPs. Forty-six percent of participants were herbalists (27%), TBS, and TBAs (27%). Most participants (82%) were Annang, and (18%) were Ibibio first-language speakers. Three major themes emerged from the data analysis: (i) Existing ethical framework related to IC, (ii) knowledge of consent, and (iii) application of IC during traditional medical practice. These themes and relevant subthemes were explored. All (100%) THPs agreed that it was essential to communicate risks and benefits while allowing patients to ask questions before treatment. All participants (100%) stated that risk communication is essential in ATM, whereas 36% said they communicated all therapy benefits to their patients. Respondents believed patients could make an informed choice if they had complete information disclosure. However, THPs in this study had limited knowledge of formal IC rules and regulations. Conclusions: This study revealed that THPs in this setting disclose a diagnosis, risks, some benefits, and treatment options to patients. Consent/agreement was obtained verbally and voluntarily during ATM practice, consistent with IC doctrine. THPs had limited knowledge of the critical elements of IC. However, they suggested that a form of IC that does not conflict with traditional African norms could be applicable in ATM. IC could facilitate documentation and help reduce risks in ATM practice.

Synergy between Skilled and Traditional Birth Attendants on Quality of Maternal and Newborn Care in Nigeria

Maternal and newborn health remains a critical challenge in Nigeria, with high maternal and neonatal mortality rates persisting in many regions. The coexistence of formal healthcare systems with traditional birth practices provides a unique opportunity for synergy between Skilled Birth Attendants (SBAs) and Traditional Birth Attendants (TBAs) to improve the quality of maternal and newborn care. This study explores the potential benefits of collaboration between SBAs and TBAs in Nigeria and investigates the barriers and facilitators to such cooperation. The findings highlight the complementary strengths of SBAs and TBAs. SBAs bring formal medical training, evidence-based practices, and access to medical resources, while TBAs possess cultural knowledge, community trust, and local birthing expertise. Through joint training and capacity building initiatives, TBAs can be equipped with updated medical knowledge, improving their ability to identify high-risk pregnancies and refer cases to skilled healthcare providers effectively. Effective referral systems play a pivotal role in ensuring timely access to emergency obstetric care. Challenges to collaboration include cultural and traditional beliefs, language barriers, limited access to resources, and legal and regulatory obstacles. Addressing these barriers requires a comprehensive approach that promotes cultural sensitivity, mutual respect, and inclusiveness within the healthcare system. The study concludes that harnessing the synergy between SBAs and TBAs can lead to a more integrated and effective maternal and newborn healthcare system in Nigeria. By leveraging the strengths of both groups and creating an enabling environment for collaboration, Nigeria can make significant strides towards reducing maternal and neonatal mortality, improving the quality of care, and achieving better health outcomes for mothers and newborns. Continued research and collaborative efforts are essential to capitalize on this synergy and drive positive change in maternal and newborn healthcare across the country.

EVALUASI PEMBANGUNAN KESEHATAN DALAM UPAYA PENURUNAN ANGKA KEMATIAN IBU DAN BAYI DI KABUPATEN MALANG

Health is one of the basic human rights that must be guaranteed by the state. The success of health development is reflected in the reduction in maternal and child mortality as an indicator of successful regional development. The high maternal mortality and infant mortality rates are a strategic issue in the 2021-2026 Regional Medium-Term Development Plan (RPJMD) of Malang Regency. This study aims to describe and evaluate health development as an effort to reduce maternal and infant mortality in Malang Regency. The type of research used is descriptive with a qualitative approach. The evaluation method used is CIPP which consists of Context, Input, Process, and Product. The CIPP technique is used for sectoral development assessment, in this case the health sector for mothers and babies with a regional apparatus, namely the Health Office of Malang Regency. The data analysis used was Creswell's qualitative data analysis. The evaluation results show that there are still several obstacles in the development of maternal and infant health as an effort to reduce maternal and infant mortality in Malang Regency. These obstacles include: not optimal quality and quantity of paramedics, affordability and access to health facilities are not evenly distributed in several villages, as well as some people who prefer traditional birth attendants in providing assistance because the community considers it cheaper.

TRADISI TUJUH BULANAN DALAM PERSPEKTIF HUKUM ISLAM DAN HUKUM ADAT ( Studi Kasus Di Desa Pohsangit Lor Kecamatan Wonomerto Kabupaten Probolinggo )

The research conducted by the author is to find out the law of carrying out the Seven Monthly Bathing Tradition according to the views of Islamic law and customary law in Pohsangit Lor Village, Wonomerto District, Probolinggo Regency. This type of field research is the type of research that the author does accompanied by the use of descriptive qualitative research methods with a Phenomenological approach. Because this research leads to the form of phenomena that exist in society, the results of this research will be in the form of descriptive written or spoken words from living people and behavior available in various ways to interpret experiences through interactions with others. The results of the data obtained by the author are sourced from books, articles, journals and from the results of interviews that the author has conducted including with local community leaders, one of the elders in the village, traditional birth attendants and local residents. The results of the study state that the implementation of the Seven Monthly Bathing Tradition does not contain elements of shirk in it because the ceremony carried out today has occurred religious acculturation so that it contains many values of benefit for people who carry it out. Therefore, some scholars made a fatwa that the tradition is permissible, meaning that it is permissible if the community wants to carry it out but there is no obligation in it. Meanwhile, according to customary law, the implementation of the Seven Monthly Bathing Tradition has a mandatory nature in it because it is to maintain the preservation of customs and also pamali according to one of the elders there if they leave the tradition.
 Keywords: Seven Monthly Bathing Tradition, Islamic Law, Customary Law.

Understanding antenatal care use in pastoralist communities: a focused ethnographic study in Kenya

Background/Aims The provision of high-quality antenatal care improves maternal and child health outcomes. Pastoralist communities face unique challenges in accessing healthcare associated with a nomadic, marginalised lifestyle, and have high rates of maternal morbidity and mortality. There is minimal evidence on antenatal care use globally among this group. To develop optimal services for pastoralist communities, there is an urgent need to understand pastoralist women's use of antenatal care services. This study's aim was to explore experiences of antenatal care among pastoralist communities in Kenya, to identify key barriers and facilitators of uptake. Methods This focused ethnographic qualitative study was underpinned by a philosophy of critical realism. A total of 58 participants (women, husbands, traditional birth attendants and nurses) were included. Data were collected using interviews, focus group discussions and observation. Data were collected for 6 months in six villages and five health facilities in a pastoralist region of northern Kenya. Inductive thematic analysis and retroduction were used to identify concepts, structures and mechanisms that influenced antenatal care use. Results Pastoralist women's antenatal care experiences and use were linked to two main themes. The first was government policies that incentivised antenatal care use by linking the provision of the baby's health and citizenship records to antenatal care uptake and encouraging traditional birth attendants to adopt defined referral roles. The second highlighted multiple structural barriers that impeded consistent antenatal care uptake, including the pastoralist lifestyle, cultural barriers, health system constraints and a gap in information sharing. The dissonance between these led to partial, sub-optimal use patterns of antenatal care. Conclusions Government policy created an impetus for the pastoralist community to use contemporary healthcare services. At the same time, multiple barriers impeded access to services. This explains the partial use of antenatal care services among pastoralist communities. The findings throw doubt on the feasibility of antenatal care guidelines that recommend eight contacts during pregnancy. There is a need to work collaboratively with communities to develop context-specific models of care.

Keterlibatan Dukun Bayi Dalam Pertolongan Persalinan

One of the Sustainable Development Goals is to reduce the Maternal Mortality Rate in 2030 to 70 deaths per 100,000 live births. In 2022 the number of deliveries in Tegal Regency is 26,679 (96.41%) vaginal deliveries 26,282 (95.6%) assisted by health workers in health care facilities 241 (0.9%) are in non-health care facilities 156 (0 .6%) assisted by non-medical health workers. In 2022, 13 maternal deaths are dominated by 60% postpartum hemorrhage, 20% embolism, 10% edema, and others. The Bumijawa Community Health Center is the largest number of delivery assistance places in Tegal Regency. In 2022 there will be 1,685 vaginal deliveries consisting of 87.7% health workers and 5% non-health workers; even though the target is 97%. The purpose of this study was to determine the involvement of traditional birth attendants in assisting with childbirth. Data collection was carried out by in-depth interviews and data reduction, demonstrated by narration, using the triangulation method, and analyzed by saturated samples. The research informants were 3 mothers who had given birth with a dukun as the main informant, 3 dukun and a midwife as triangulation informants. The results showed that the mother's decision to choose birth attendants was related to experience, knowledge, attitudes, access to services, husband and family support, local culture; This can be seen from the level of public awareness of health which is still low

Sociocultural practices, beliefs, and myths surrounding newborn cord care in Bayelsa State, Nigeria: A qualitative study.

Persisting sociocultural beliefs have continued to significantly influence the adoption of recommended newborn care practices by women in Sub-Saharan Africa. This study aimed at identifying the sociocultural practices, beliefs, and myths surrounding newborn cord care by women residing in Bayelsa State, Nigeria. This was a qualitative study that involved 24 women and 3 traditional birth attendants (TBAs) in three focus group discussions and three in-depth interviews respectively. Interview guides were used to lead the discussions and the interviews which were audiotaped, translated and then transcribed. Thematic analysis was done using NVivo QSR version 12.2 Pro. Several themes describing various sociocultural practices, beliefs, and myths surrounding cord care were uncovered. Most women preferred to be delivered by a TBA who usually cuts the infant's cord with a razor blade and ties the stump with hair or sewing thread. Substances used for cord care included methylated spirirt, "African never-die" leaf, and "Close-Up" toothpaste. All the participants agreed that methylated spirit was a potent antiseptic for cord care but none of them had heard about nor used chlorhexidine gel. It was a common belief that abdominal massage and the application of substances to the cord were solutions to common cord-related problems. Mothers, TBAs and relatives were influential regarding choices of cord care practices. Sociocultural practices, beliefs, and myths are still major barriers to the adoption of recommended cord care practices by women in Bayelsa State. Interventions should be targeted at improving delivery in health facilities and educating women in the community on good cord care practices.

Overview of Traditional Birth Attendance in Nigeria

Traditional Birth Attendance (TBA) has played a significant role in maternal healthcare in Nigeria for centuries. This paper provides an overview of Traditional Birth Attendance practices in Nigeria, exploring the conceptual analysis, determinants of traditional birth attendance usage, mothers’ reasons for Choosing TBAs for delivery services, and integration into the Health Care System. The paper highlights the essential role of TBAs in preserving cultural heritage, community support, and local knowledge related to childbirth. However, it also identifies numerous challenges associated with TBA practices, including inadequate training, limited medical knowledge, unhygienic birthing conditions, and the potential risks of complications during childbirth. In conclusion, this overview sheds light on the complex landscape of Traditional Birth Attendance in Nigeria. The coexistence of traditional practices and modern healthcare systems presents unique challenges and opportunities. A balanced approach that respects cultural traditions, while prioritizing safe and skilled birth attendance, holds the potential to enhance maternal and child health outcomes in Nigeria. Further research and collaborative efforts are needed to create an integrated and comprehensive healthcare system that caters to the diverse needs of the Nigerian population.

Ethnobotany of medicinal plants in the Dayak Linoh Tribe in Sintang District, Indonesia

Abstract. Julung H, Supiandi MI, Ege B, Zubaidah S, Mahanal S. 2023. Ethnobotany of medicinal plants in the Dayak Linoh Tribe in Sintang District, Indonesia. Biodiversitas 24: 767-775. The Linoh Dayak people have long used medicinal plants to deal with health problems in their community. However, along with the advancement of science, the influx of foreign cultures and the degradation of nature and the environment, traditional knowledge about medicinal plants is only owned by the older generation, and the transmission of information is limited by word of mouth and not well documented. This study aimed to document various medicinal plants used by the Dayak Linoh people. The research used a qualitative approach using field surveys. Informants were selected using the purposive sampling method. The informants interviewed consisted of customary leaders (key informants), village heads (main informants), and recommended informants, such as traditional birth attendants (village midwives), hamlet heads, and community members who know medicinal plants. Medicinal plant data were obtained through in-depth interviews, participatory observation, and documentation related to the local names of the plants, the parts used, and how to manage and use them. Data analysis was carried out in a qualitative descriptive manner. The results showed that 55 species of medicinal plants consisting of 34 plant families were used by the Dayak Linoh tribe. The most widely used part of the plant is the leaf (39, 71%). People in the community boiled the leaves and drank the extract. The most used families in the three tribal communities of the Dayak Linoh tribe, were Zingiberaceae (9 species) and Myrtaceae (3 species). The plant parts used by the Dayak Linoh tribe were root, tuber, rhizome, stem, bark, banana heart, fruit, fruit skin, leaf, and seed. The Dayak Linoh tribe used medicinal plants to treat boil (7 plants) and for postpartum stamina recovery (7 plants). The communities processed and used the medicinal herbs conventionally by boiling and drinking.

Traditional and cultural newborn care practices in the Dakace and Tsibiri communities of Nigeria: an ethnographic study

Traditional and cultural practices related to newborn care have been passed down through generations in various cultures worldwide, often with the belief that they are effective in improving the health and well-being of newborns. These practices can differ significantly between cultures. The aim of this study was to assess the traditional and cultural newborn care practices in the Dakace and Tsibiri communities of Nigeria, and to identify potential opportunities for the integration of these practices into modern healthcare approaches. An ethnographic study was conducted in the Dakace and Tsibiri communities of Nigeria, which involved observing 54 deliveries and traditional rituals surrounding newborn care through participant observation. A total of 30 participants, including traditional birth attendants, community health workers, traditional leaders, and mothers who had given birth within the past year, were included in the study, and participated in in-depth interviews and focus group discussions. The main themes that emerged from the data included the provision of warmth, nutrition, cord care, and traditional medication. In these communities, there is a strong emphasis on keeping newborns warm and providing proper nutrition, including breastfeeding and the use of traditional remedies. Cord care is also considered important, with the umbilical cord typically cut with a new razor blade and the stump treated with hot compresses and oil massages. Traditional and cultural beliefs also influence the use of traditional medication, including the use of traditional remedies to address common pregnancy-related health issues and the importance of proper nutrition during pregnancy. The study also identified the important role of fathers and other male family members in childbirth preparation. The findings of this study provide valuable insights into the traditional and cultural practices of newborn care in the Dakace and Tsibiri communities of Nigeria and identify potential opportunities for integrating these practices into modern healthcare approaches in a way that is safe and effective for the mother and child. These findings may be of interest to healthcare professionals, researchers, and policy makers working in maternal and child health, as well as to members of the Dakace and Tsibiri communities.

Determinants of Antenatal Care Access and Utilization in Haiti

Several pregnancy-related complications resulting in maternal mortality in low-income countries may be due to inaccessible or under-utilized antenatal healthcare services. This study aims to assess the sociodemographic characteristics of Haitian women and how these may affect their access to and use of antenatal care services (ANC) during pregnancy. Multi-logistic regression was used to analyze sociodemographic factors associated with ANC access and use among a cross-section of Haitian women (N = 4890) from the Demographic and Health Survey Haiti (2016–2017). Approximately 18.2% of the women had no education, 40.2% had secondary education, and 4.0% had higher education. About 45.6% of women with no education, 95% with higher education, and 76% of urban dwellers made four or more ANC visits. Only 3% of those who used public sector ANC had a higher education, and over 64.2% of those who used private sector ANC lived in urban areas. Rich women (OR = 2.49, 95% CI = 2.02–3.08) vs. poor women and mature mothers (OR = 1.97, 95% CI = 1.42–2.73) vs. teenage mothers both had higher odds of using ANC services four or more times. Women with higher education (OR = 0.19, 95% CI = 0.12–0.30) and those who were rich (OR = 0.67, 95% CI = 0.5–0.89) had lower odds of using public sector ANC vs. private sector ANC. Wealth and education are protective of ANC access and use by Haitian women. As over half the population has home births, public health education interventions targeting traditional birth attendants are recommended. Interventions training traditional birth attendants to provide better ANC during pregnancy and at the time of birth and to access skilled help during emergency deliveries is recommended.

Culture, traditional beliefs and practices during pregnancy among the Madurese tribe in Indonesia

Background Understanding cultural context is crucial to providing respectful maternity care. This study’s aim was to explore pregnancy culture, beliefs and traditions among the Madurese tribe of Indonesia. Methods This qualitative study was conducted in the Sumenep district. In-depth interviews and focus group discussions were held with 67 key informants: pregnant women, their family members, traditional birth attendants, and community, religious and traditional/indigenous leaders. Results The practices included fourth-and seventh-month rituals, pregnancy massage and behavioural taboos and suggestions. Conclusions Most Madurese tribe practices are harmless. Healthcare providers must appreciate and integrate prevailing traditional beliefs and practices with other efforts to reduce maternal mortality.

Tuberculosis management and referral practices among traditional medicine practitioners in Lagos, Nigeria.

Despite the potential role of Traditional Birth Attendants (TBAs) and Traditional Healers (THs), little is known about their knowledge of tuberculosis (TB) management and referral practices in Nigeria. To determine knowledge and self-reported practices of traditional birth attendants and traditional healers in managing TB in Lagos, Nigeria. A cross-sectional study of 120 THs and TBAs in three high TB burden Local Government Areas (LGAs) in Lagos, Nigeria. Data were collected between April 2018 to September 2018 through interviewer-administered questionnaires. We used Statistical Package for Social Sciences software for data analyses. Independent predictors of being TBA or TH were determined using logistic regression at the statistical significance of P<0.05 and 95% confidence interval. TB knowledge increased from 52.7% pre-test to 61.7% post-test and did not differ between TBAs and THs. Of the 120 Traditional Medical Practitioners studied, 70% (84) never treated TB; 57.3 % (69) ever referred chronic cough patients to a health facility; 90% (108) were willing to collaborate with National Tuberculosis, Leprosy and Buruli Ulcer Control Programme (NTBLCP), 85% (102) attached monetary and token incentive as a condition for the collaboration. THs had decreased odds of ever referring TB patient to the hospital (AOR: 0.3, 95% CI:0.14-0.64, P=0.002); currently referring TB patients (AOR: 0.06, 95% CI:0.02-0.17, P<0.0001) and consulting <40 patients in a year (AOR: 0.22,95% CI:0.09-0.53, P<0.0001). Majority of the THs and TBAs were willing to collaborate with NTBLCP in the identification and referral of Presumptive TB patients. We suggest that NTBLCP empowers the TBAs and THs to help with an early referral of TB patients.