Towards the participation of traditional birth attendants in primary health care in Kenya
Sindiga, I.
East African Medical Journal 72(7): 459-464
1995
ISSN/ISBN: 0012-835X PMID: 7498031 Document Number: 302828
During 1989-1990, interviews were conducted with 80 female traditional birth attendants (TBAs) in Kendu, Homa Bay district, Kenya, to examine their knowledge, functions, and participation in maternal and child health and family planning. Most TBAs learned through an apprenticeship with their mothers and grandmothers. All had been trained in primary health care. 79% provided prenatal care. 76% said pregnant women should not eat certain foods (e.g., meat, bananas) and use certain drugs (e.g., alcohol, cigarettes) and substances (e.g., soil). TBAs tended to administer herbal medicines to pregnant women. They watched for certain danger signals in pregnant women (e.g., body swelling, convulsions, persistent vomiting, vaginal bleeding). 70% had seen or known pregnant women who had convulsions. 14% considered convulsions to be normal in pregnancy. Only 14% would refer a pregnant woman with convulsions to a hospital. For tools, the TBAs had a tool for cutting the umbilical cord, gloves, cotton, and thread/string. 81% boiled the tools to sterilize them. 78% inserted their fingers in the vagina of a woman in labor to guide the baby's head. 12% admitted to ever having delivered a woman who died while giving birth. 84% delivered women who were pregnant for the first time. 93% put something (e.g., talcum powder) on the cord to hasten its drying and falling off. TBAs tended to care for the newborns and their mothers during the first month and sometimes thereafter. 34% gave newborns herbs (e.g., orange leaves). 76% gave new mothers herbs or special foods. All TBAs knew about family planning and had ever advised women to practice it. 95% knew that family planning limits or spaces pregnancies. 89% approved of family planning. 79% knew a method, especially the pill. Most TBAs promoted the pill and condom use. 97% had recommended their clients to go to a health facility for maternal care in the last year. All TBAs would work with the staff of the local health center on maternal and child health. 72% worked full-time. 70% had charged fees. 79% always kept record of deliveries.