A needs assessment study of traditional birth attendants in rural Kenya.

Abstract

For several reasons traditional birth attendants (TBAs) still deliver the majority of women in many developing areas of the world. A needs assessment study of TBAs serving one area of Kenya was conducted for the purpose of designing an appropriate intervention program. Thirty-six TBAs were interviewed. Together, they had attended to a total of 116 deliveries within 1 month. The local hospital was conducting an average of 37 deliveries per month. Although most TBAs were good at abdominal palpation, they did not conduct routine prenatal checks and rarely referred their clients to hospital. Several risky practices were identified from which a training program has been designed. The findings and their implications are discussed within the context of improved MCH/FP services. PIP:For several reasons traditional birth attendants (TBAs) still deliver the majority of women in many developing areas of the world. A needs assessment study of TBAs serving 1 area of Kenya was conducted for the purpose of designing an appropriate intervention program. 36 TBAs were interviewed. Together, they had attended to a total of 116 deliveries within 1 month. The local hospital was conducting an average of 37 deliveries per month. Although most TBAs were good at abdominal palpation, they did not conduct routine prenatal checks and rarely referred their clients to hospitals. TBAs practice several risky methods including external cephalic version (ECV) without knowing the contraindications; lack of antenatal referral when patients are anemic or suffering from antepartum hemorrhage; lack of referrals for prolonged labor; lack of sterility and asepsis; poor handling of the cord; and use of poorly chosen instruments during delivery. The delay of referrals gives hospitals only a minimal chance of saving both mother and child. Recommendations included training and articulation of TBAs, especially on antenatal care, labor, sterility, asepsis, the referral system, postnatal care, and family planning. Further research on the composition of the herbal medications used by TBAs was also recommended