Changing the role of the traditional birth attendant in Somaliland
Open Access
- 4 June 2014
- journal article
- research article
- Published by Wiley in International Journal of Gynecology & Obstetrics
- Vol. 127 (1), 41-46
- https://doi.org/10.1016/j.ijgo.2014.04.009
Abstract
Objective: To explore the feasibility of changing the role of the traditional birth attendant (TBA) to act as birth companion and promoter of skilled birth attendance. Methods: Between 2008 and 2012, 75 TBAs received 3 days of training and were paid US $5 for each patient brought to any of five healthcare facilities in Maroodi Jeex, Somaliland. Health facilities were upgraded (infrastructure, drugs and equipment, staff training, and incentivization). Eight key informant interviews (KIIs) and 10 focus group discussions (FGDs) involving 32 TBAs and 32 mothers were conducted. A framework approach was used for analysis. Results: TBAs adopted their new role easily; instead of conducting home births and referring women to a facility only at onset of complications, they accompanied or referred mothers to a nearby facility for delivery, prenatal care, or postnatal care. Both TBAs and mothers accepted this new role, resulting in increased deliveries at health facilities. Facilitating factors included the creation of an enabling environment at the health facility, acceptance of the TBA by health facility staff, and monetary incentivization. Conclusion: Changing the role of the TBA to support facility-based delivery is feasible and acceptable. Further research is needed to see whether this is replicable and can be scaled-up. (C) 2014 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.Funding Information
- European Union (Sante/2007/127-496)
- European Union (Sante/2007/127-496)
This publication has 14 references indexed in Scilit:
- Addressing maternal healthcare through demand side financial incentives: experience of Janani Suraksha Yojana program in IndiaBMC Health Services Research, 2012
- A Qualitative Evaluation of the Choice of Traditional Birth Attendants for Maternity Care in 2008 Sierra Leone: Implications for Universal Skilled Attendance at DeliveryMaternal and Child Health Journal, 2012
- The impact of emergency obstetric care training in Somaliland, SomaliaInternational Journal of Gynecology & Obstetrics, 2012
- How the integration of traditional birth attendants with formal health systems can increase skilled birth attendanceInternational Journal of Gynecology & Obstetrics, 2011
- Monitoring and evaluation of skilled birth attendance: A proposed new frameworkMidwifery, 2011
- An Intervention Involving Traditional Birth Attendants and Perinatal and Maternal Mortality in PakistanThe New England Journal of Medicine, 2005
- Effect of Shifting Policies on Traditional Birth Attendant TrainingJournal of Midwifery & Women's Health, 2004
- Is there a place for traditional midwives in the provision of community-health services?Pathogens and Global Health, 1997
- Too far to walk: Maternal mortality in contextSocial Science & Medicine (1982), 1994
- Traditional birth attendantsInternational Journal of Gynecology & Obstetrics, 1985