She said she only trusted her instincts to be able to do it. Away from conflict zones, TBAs are found within many communities and there are many reasons pregnant women opt for them, even when there is a primary health facility in close vicinity. A senior member of staff at the Head Office of the Nursing and Midwifery Council of Nigeria, who preferred not to be named, said the council is not concerned with regulation of TBA practice and that she personally knows nothing about it.
Skilled birth attendants recognise these 5% and offer interventions that reduce morbidity and mortality, while traditional birth attendants are lulled by the false confidence of satisfactory delivery of the 95% that would have delivered without any intervention. An evaluation of the knowledge and practices of trained traditional birth attendants in Bodinga, Sokoto State, Nigeria. She has taken deliveries without gloves in the past, before the training, and shared the story of delivering a baby inside a tent during a thunderstorm. BMC Pregnancy Childbirth. The Lagos State Government recently disclosed that TBAs accounted for 14,536 deliveries in 2015, lower than the previous year when there were 23,229 deliveries from 809 registered TBAs. The majority had gone to traditional birth attendants like Aunty Dada and Liyatu. The women also preferred the TBAs who understood their culture and way of life. You can follow any responses to this entry through the RSS 2.0 feed. The country has invested heavily in training midwives and most deliveries are attended by a skilled birth attendant, who also visits the families, educates them and encourages them to visit the primary health clinics. Training these unskilled (TBA’s) but important workforce (assets) as currently happening in many communities as described in Chibuike’s paper is the best way forward. Bull World Health Organ. Rakia Adamu, another camp resident, is currently pregnant.
I don’t think the dearth of skilled health workers is the reason. If we do all these and provide much needed lifesaving commodities and basic equipment , maternal mortality in Nigeria will crash. The training took place in the Gwoza and Bama IDP camp in Durumi, and the TBAs were taught modern delivery methods. Every trained HCW is looking for greener pastures- the ones in the villages are moving to the city, the ones in the city are moving to bigger cities and the ones in bigger cities are leaving the country. It is a great challenge for delivery specialist like midwives to operate in “Hospitals with out walls” like IDP centers where there are great needs for them than remaining in hospital with walls and doing nothing or a little. -, Imogie AO, Agwubike EO, Aluko K. Assessing the role of traditional birth attendants (TBAs) in health care delivery in Edo State, Nigeria.
A dire situation complicated by insecurity. NIH Conclusion and global health implications: They also provided basic delivery materials like hand gloves, chlorhexidine cream and cut clamps for the umbilical cord and taught the TBAs how to use them. Utilizing TBAs in Nigeria on a national level would not be simple and would require the full support of international agencies already working in the country. Impact of Traditional Birth Attendants on maternal health in Nigeria
Specific areas of training for TBAs that were identified and recommended in review including: recognizing delivery complications, community support for TBA practices through policy, evaluation of TBA training programs and increasing collaboration between healthcare facilities and TBAs. On that occasion, just as the baby emerged, the storm blew the tent away and they all got drenched, – baby, mother and Liyatu. The rates are the best in south east asia, considering that there is a significant population that is rural and with poor infrastructure. Clipboard, Search History, and several other advanced features are temporarily unavailable.
Change ). Let the government offer free maternal healthcare and let’s watch the tide change. Poverty, cultural practices and a shortage of primary healthcare services are forcing women in Nigeria to seek the help of untrained traditional birth attendants, despite the serious risks involved. This is worse in West and Central African countries facing insurgencies or other humanitarian emergencies, where the maternal mortality rate is as high as 746 per 100,000 live births. Traditional birth attendants are part of the socio-cultural fabric of various communities in Nigeria (14). Even without the present insecurity challenges, there is much work to be done in Nigeria to reduce the maternal mortality rate. As outlined in the article, the TBAs that were discussed were in a conflict area. Aunty Dada admits that in the past she would get scared if the pregnant woman had suspected postpartum haemorrhage, this is where women bleed profusely after giving birth.
Under the circumstance that we lacking of professional healthcare worker at the rural areas, It was best the utilize the existing valuable human resource to such as TBAs. Morgan and Zigilo (2007, 2010) emphasise the importance of asset mapping as a starting point. A 2015 statistics brief by the United Nations Population Fund (UNFPA) shows that maternal mortality in humanitarian and fragile settings is 1.9 times higher than the world average. All over Africa, governments are introducing (or announcing) free healthcare for pregnant women and children under 5 years in the rush to meet the United Nation’s millennium development goals on reducing maternal and child mortality.
The author has brilliantly presented the facts and has asked a very valid question of whether the government should direct its effort and resources towards the training TBAs as a stopgap measure or focus on initiatives that will improve access to healthcare for all women.
But it does require a strong political will. The country currently has the fourth highest maternal mortality ratio with 814 maternal deaths/100,000 births and without drastic changes, Nigeria's women will continue to die from preventable causes. Many communities in Nigeria rely heavily on traditional birth attendants while most pregnant women in Nigerian communities often complain that they get harsh treatment with less care and disrespect for no reason from nurses and midwives in public hospitals when they visit , especially during child delivery preferring to go to a traditional birth attendant who treats them with more dignity … We should also provide health insurance cover for all pregnant women and pay TBAs for identifying and referring women in labour. Get the latest research from NIH: https://www.nih.gov/coronavirus. It is the 5% that causes all the difference in maternal mortality ratio that is the crunch. Dr. Godwin Ntadom, a Gynaecologist and Chief Consultant Epidemiologist of the Federation in the Ministry of Health, strongly believes TBAs have increased the maternal mortality rate in the country rather than reduce it. Joseph Ana argues that the shortage of skilled health workers means traditional birth attendants have a valuable place, but Kelsey A Harrison(doi:10.1136/bmj.d3308) believes they do more harm than good
She says Aunty Dada delivered her last two babies, and her satisfied smile makes it clear that she plans to come to her when she goes into labour. Her first attempt at helping a woman deliver a baby was in a forest while escaping from insurgents. Joseph Ana, former commissioner for health, Cross River State, Nigeria Best to reskill them for alternative careers and advice them to promptly refer. The state government is now working to regulate and monitor their practice through the Traditional Medicine Board which issues practicing licenses to the TBAs.
What we need is innovative ideas on how to better use our TBA’s. She had already seen several pregnant women die in childbirth in the forest and so at that point, she felt she had only two options. Fatima said she prefers using Aunty Dada for her deliveries because she charges little to nothing and treats her with respect. Much work still needs to be done. 2019;8(1):11-18. doi: 10.21106/ijma.264. Skilled birth attendants recognise these 5% and offer interventions that reduce morbidity and mortality, while traditional birth attendants are lulled by the false confidence of satisfactory delivery of the 95% that would have delivered without any intervention. Top Ten News Items on Health, 13th July 2018. What is the evidence on the balance between the harms and benefits of using TBAs? A literature review of two major electronic databases was conducted using the PRISMA framework to identify English language studies conducted between 2006 and 2016. 2011 Nov;115(2):127-34. doi: 10.1016/j.ijgo.2011.06.019. [February 27 2017].
Primary health centres have to do better in terms of respect and cost if they want to woo women to use their facilities for giving birth. I find it so interesting that women choose to use TBAs not just because of the lower cost but also because of the way they are treated. Obasohan PE, Gana P, Mustapha MA, Umar AE, Makada A, Obasohan DN. Mapping will also help to identify the most appropriate ‘asset indicator’ to be used in evaluation of the performance of trained TBA’s in the community. birth attendants to do the job. Could training TBAs like Liyatu and Dada to help women deliver safely be one way of providing a stopgap measure until the health system is able to break down the barriers that prevent women from accessing care? Sensitization is also required at the communities and PHCs especially during immunization activities. 95% of deliveries will occur without any form of assistance or intervention in a pregnant woman. Keywords:
Policies focused on improving access to health services and importantly, formal health education training to TBAs, are required to improve maternal health outcomes and underserved communities. However, with this support, Nigeria could accomplish the task. Fatima Mohammed, who resides in the Kabussa camp has successfully given birth to two children since relocating from Gwoza three years ago. This entry was posted on March 11, 2019 at 11:28 pm and is filed under Health Care Reform, women's health. More investment in training the TBAs could be a way to improve their skills and the outcomes of pregnant mothers. However, what these countries have done in areas where there is a shortage of HCWs is to upskill individuals in the community e.g. The KLF team then came up with a new solution- bringing all the TBAs practicing in 23 IDP camps around Abuja together, to build their capacity in performing safe deliveries. Epub 2011 Sep 14. In these circumstances, the mother would have been in a very fragile physical and mental state and the TBA was nearby at that moment. Methodology: All the TBAs identified through snowball method within the LGA consented to The challenge is, how can you teach an old dog new tricks? Head To Head Social, Cultural and Behavioral Foundations of Primary Health Care (JHSPH), Social, Cultural & Behavioral Issues in PHC & Global Health, Support Funding to End HIV/AIDS in the Dominican Republic, Increasing Access to HPV Prevention and Education Services in Rural Mississippi, Sierra Leone, Central African Republic, and Chad. Adams said the training involved first unlearning some of the harmful practices by the TBAs like using toothpaste for the umbilical cords, tying umbilical cords with clothes and vigorously shaking the newborn after delivery. Great Article.When you are poor the only available option seems like the best option.Elites tell the difference from delivering a baby in Nigeria and another in US or UK.TBAs are patronized because they are the only option.The cost of healthcare at govt hospitals and TBAs is close or equal.Butvthe fashion in which it is collected is the catch.You can pay some and pay the rest later.In the hospital u pay before delivery.The hidden cost of transport,waiting time and bureaucracies that can be avoided and even language barrier makes the TBas acceptable.
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