Tag Archives: traditional birth attendants (TBAs)

New research explores why women deliver alone in Nigeria

In general, discussions about care during labor and delivery tend to focus on two groups: women who deliver with assistance from a skilled birth attendant, such as a midwife or doctor, and those who do not, as giving birth with assistance from a skilled provider is often considered the single most important intervention for ensuring that women deliver safely. In most settings, women in the second group give birth with assistance from someone, usually a traditional birth attendant. However, in some places, including Nigeria, where one in seven of the world’s maternal deaths occur, this group also includes women who give birth entirely alone. In “When women deliver with no one present in Nigeria: who, what, where and so what?“an article published earlier this month in PLOS ONE,  Bolaji M. Fapohunda and Nosakhare G. Orobaton, explore the factors that contribute to making the practice of giving birth with no one present (NOP) so common.

Using data from the 2008 Demographic and Health Survey, the authors assessed a wide variety of factors that might contribute to the high proportion of NOP births and, in turn, may offer clues for efforts to change this situation. The authors found that the practice is heavily concentrated in the northern part of Nigeria, and associated with a set of sociodemographic, economic and social issues.

From the article:

Mother’s education, higher wealth quintiles, urban residence, decision-making autonomy, and a supportive environment for women’s social and economic security were inversely associated with NOP deliveries. Women’s autonomy and social standing were critical to choosing to deliver with skilled attendance, which were further amplified by economic prosperity. . . Programs that seek to improve the autonomy of women and their strategic participation in sound health seeking decisions will, most likely, yield better results with improvements in women’s education, income, jobs, and property ownership. As a short term measure, the use of conditional cash transfer, proven to work in several countries, including 18 in sub-Saharan Africa, is recommended. 

They also note that these sort of demand-side approaches are not the only – and may not even be the most important – factors, given that there are severe shortcomings in access and quality of maternal health services.

A Road Less Travelled highlights gap in maternal health services for Kenya’s Maasai communities

A Road Less Travelled, which is a partnership project led by Anglican Overseas Aid, Australia that supports nomadic pastoralists to improve maternal and child health within their communities in Ethiopia and Kenya, featured a blog post this week underscoring the challenges that go with efforts to fill the gap in health service coverage for women in Maasai communities in Kenya raising several questions about the role of traditional birth attendants within efforts to improve maternal health in these communities.  

From the blog post:

The question now is: what can be done to bridge the gap? Could empowering the TBAs more help to bridge the gap, and contribute more towards safer deliveries? Should training be provided to TBAs to improve their skills? Should they be linked with the formal health system so that TBAs and professional health workers act collaboratively to assist women during pregnancy?

To view the GMCH2013 video and PowerPoint presentation  by James Senjura of the Mothers’ Union of the Anglican Church Kenya (MUACK), A Road Less Traveled’s partner in Kenya, click here.

For additional information, visit A Road Less Traveled’s Blog here and their January guest post on this blog here.

Weekend Reading

This week on the MHTF blog:

  1. We heard from CIESAS and their evaluation of a Mexican Ministry of Health program
  2. The Department of Community Medicine at Rajarata University of Sri Lanka told us about their focus on maternal morbidity
  3. CEDPA updated us on their project to integrate maternal health into HIV/AIDS programs

Some reading for the weekend:

  1. Health care professionals and the provision and use of maternal care in Vietnam
  2. Ugandan MPs want to legalize abortion
  3. Ugandan women and traditional birth attendants

Article of the Week

Pakistan: Midwives Gain Recognition But Concerns Remain

Inter Press Service News Agency

pakistan map image 2

Three years ago, Kanwal Gul participated in a one-week training in community midwifery as part of a UNICEF pilot project—and now she runs a birthing center in her village, just north of Karachi.

“…Qadir Dino, the village councilor, credits Gul for the decline in maternal deaths in Gul’s village. ‘Fewer mothers are dying while giving birth,’ he says, albeit without citing any data.

‘Earlier, whenever there was a (pregnancy) complication, we would rush the expectant mother to any of the hospitals in the adjoining towns of Hala and Bhit Shah,’ says Dino.

Transport is a big problem, he says, since it is also very expensive. ‘And once we reach the hospital, there is no guarantee that they (the medical staff) will entertain us, since we’re poor and uneducated. We usually run from pillar to post, and even after paying are unable to get quality treatment,’ Dino explains.

‘With the birthing station, at least we know that if there is a complication, Gul will handle it or refer us to the hospital, and with her note, we can now expect them (hospital staff) to attend to our patients,’ says Shah Khatoon, mother of four.

A UNICEF birthing station project helped ensure the development of a strong referral system of community midwives (CMWs) with doctors from hospitals…”

Read the full story here.

For more information on UNICEF community midwife training programs in Pakistan, click here.