Involving traditional birth attendants in emergency obstetric care in Tanzania: policy implications of a study of their knowledge and practices in Kigoma Rural District

International Journal for Equity in Health

Melchiory Masatu¹  Godfrey M Mubyazi²  Dismas B Vyagusa³ 

[1] Centre for Educational Development in Health, P.O. Box 1162, Arusha, Tanzania;National Institute for Medical Research (NIMR), Headquarters, 2448 Barak Obama/Luthuli Road (former Luthuli/Ocean Road), P.O Box 9653, Dar es Salaam, Tanzania;Singida District Council, P.O Box 354, Singida, Singida Region, Tanzania

关键词: Tanzania;    Maternal health;    Traditional birth attendants;    Pregnancy;    Obstetric care;   

Others  :  1146610
DOI  :  10.1186/1475-9276-12-83

 received in 2012-07-30, accepted in 2013-10-08,  发布年份 2013

【 摘 要 】

Introduction

Access to quality maternal health services mainly depends on existing policies, regulations, skills, knowledge, perceptions, and economic power and motivation of service givers and target users. Critics question policy recommending involvement of traditional birth attendants (TBAs) in emergency obstetric care (EmoC) services in developing countries.

Objectives

This paper reports about knowledge and practices of TBAs on EmoC in Kigoma Rural District, Tanzania and discusses policy implications on involving TBAs in maternal health services.

Methods

157 TBAs were identified from several villages in 2005, interviewed and observed on their knowledge and practice in relation to EmoC. Quantitative and qualitative techniques were used for data collection and analysis depending on the nature of the information required.

Findings

Among all 157 TBAs approached, 57.3% were aged 50+ years while 50% had no formal education. Assisting mothers to deliver without taking their full pregnancy history was confessed by 11% of all respondents. Having been attending pregnant women with complications was experienced by 71.2% of all respondents. Only 58% expressed adequate knowledge on symptoms and signs of pregnancy complications. Lack of knowledge on possible risk of HIV infections while assisting childbirth without taking protective gears was claimed by 5.7% of the respondents. Sharing the same pair of gloves between successful deliveries was reported to be a common practice by 21.1% of the respondents. Use of unsafe delivery materials including local herbs and pieces of cloth for protecting themselves against HIV infections was reported as being commonly practiced among 27.6% of the respondents. Vaginal examination before and during delivery was done by only a few respondents.

Conclusion

TBAs in Tanzania are still consulted by people living in underserved areas. Unfortunately, TBAs’ inadequate knowledge on EmOC issues seems to have contributed to the rising concerns about their competence to deliver the recommended maternal services. Thus, the authorities seeming to recognize and promote TBAs should provide support to TBAs in relation to necessary training and giving them essential working facilities, routine supportive supervision and rewarding those seeming to comply with the standard guidelines for delivering EmoC services.

【 授权许可】

   
2013 Vyagusa et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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