Electron microscopic structure of Erwinia carotovora moderate phage 59 and its DNA
Kishko, I.G.; Ruban, V.I.; Tovkach, F.I.; Murashchik, I.G.
Voprosy Virusologii 27(3): 348-354
1982
ISSN/ISBN: 0507-4088 PMID: 7123922 Document Number: 189208
Traditional birth attendants (TBAs) are now being recognized as valuable members of the health care team and some countries are adopting innovative approaches to their utilization. 71% now, as opposed to 36% of the countries where TBAs attend births, offer formal recognition through certification and licensure to these TBAs. Many are now being trained and the training programs show diversity in content, duration, and manner of operation. Basically, the incentive for TBAs has remained the same since 1972--the UNICEF midwifery kit. Some countries have stipends while others distribute uniforms. The basic problems with the TBAs are deficiencies in supervision and in evaluation. Some countries, however, are attempting to incorporate TBAs into the mainstream in these ways: incorporation of TBAs into national "health for all" strategies (in Bangladesh, they are attending more births; in the Maldives TBAs will help accomplish equitable distribution of basic health services by the year 2000); TBA training programs (2 programs in Malawi and Afghanistan are described whereby innovative training projects carried out on a local level led to the development of national TBA training programs); expansion of role of TBA to include family planning (they have been used successfully and have proven capable of adding important new services to the traditional functions; Malaysia's successful experience is described); and the use of TBAs to staff rural maternity centers. Brazil and Senegal are the sites for 2 unusual pilot programs which provide primary obstetric care to women with little access to formal health care. In Senegal, the rural maternity centers are now cooperatively run by TBAs and provide a good example of community participation in health services. It is a low-cost program with simplified health care, and use of local personnel. In Brazil, trained TBAs work in conjunction with a university-based hospital at satellite obstetric units. The emphasis is on traditional and nonaggressive techniques. While collaboration with TBAs in countries with high morbidity and mortality is resulting in progress, much still needs to be done to make full use of this resource. Better training for these TBAs is the most feasible alternative.