Stakeholder views on the incorporation of traditional birth attendants into the formal health systems of low-and middle-income countries: a qualitative analysis of the HIFA2015 and CHILD2015 email discussion forums

BMC Pregnancy and Childbirth

Neil Pakenham-Walsh¹  Simon Lewin³  Claire Glenton⁴  Onikepe Oluwadamilola Owolabi² 

[1] Global Healthcare Information Network, Charlbury, Oxford, UK;Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, Keppel Street, WC1E 7HT London, UK;Health Systems Research Unit, Medical Research Council of South Africa, Tygerberg, South Africa;Norwegian Knowledge Centre for the Health Services, Oslo, Norway

关键词: Social media;    Health manpower;    Community health worker;    Qualitative;    TBA;    Traditional birth attendant;   

Others  :  1127460
DOI  :  10.1186/1471-2393-14-118

 received in 2013-10-10, accepted in 2014-03-24,  发布年份 2014

【 摘 要 】

Background

Health workforce shortages are key obstacles to the achievement of the health-related Millennium Development Goals. Task shifting is seen as a way to improve access to pregnancy and childbirth care. However, the role of traditional birth attendants (TBAs) within task shifting initiatives remains contested. The objective of this study was to explore stakeholder views and justifications regarding the incorporation of TBAs into formal health systems.

Methods

Data were drawn from messages submitted to the HIFA2015 and CHILD2015 email discussion forums. The forums focus on the healthcare information needs of frontline health workers and citizens in low - and middle-income countries, and how these needs can be met, and also include discussion of diverse aspects of health systems. Messages about TBAs submitted between 2007-2011 were analysed thematically.

Results

We identified 658 messages about TBAs from a total of 193 participants. Most participants supported the incorporation of trained TBAs into primary care systems to some degree, although their justifications for doing so varied. Participant viewpoints were influenced by the degree to which TBA involvement was seen as a long-term or short-term solution and by the tasks undertaken by TBAs.

Conclusions

Many forum members indicated that they were supportive of trained TBAs being involved in the provision of pregnancy care. Members noted that TBAs were already frequently used by women and that alternative options were lacking. However, a substantial minority regarded doing so as a threat to the quality and equity of healthcare. The extent of TBA involvement needs to be context-specific and should be based on evidence on effectiveness as well as evidence on need, acceptability and feasibility.

【 授权许可】

   
2014 Owolabi et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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