The role of electronic media in the health services of Zambia
Chirwa, B.U.
Afya 23(1): 3-10
1995
ISSN/ISBN: 0378-4851 PMID: 12319646 Document Number: 380346
Asphyxia tends to be an important cause of perinatal mortality in developing countries. Prompt resuscitation may be crucial and may make the difference between death or completely normal survival. Where most births occur in homes or small clinic rural surroundings, it is important that traditional birth attendants (TBAs) be trained in basic resuscitation techniques. Judgement of asphyxia at birth depends on the circumstances, but essential features of vitality such as crying, breathing, and activity can be taught and recognized. A study from India reports the experience there. Without training in methods of resuscitation, TBAs were found to rely solely on traditional methods such as instillation of onion juice, milking of the umbilical cord or, in this rural area of north India, warming of the placenta. Resuscitation methods were added to the existing instruction programs: methods of clearing any obstruction of the air passages and getting air or oxygen into the lungs. To assess the effect of the program, trained field workers interviewed attendants within 2 weeks of each birth. About 3% of babies were stillborn or had been asphyxiated, and the methods taught had been used in a high proportion of these cases. The instillation of onion juice was much less used by better trained attendants, but even these attendants resorted to traditional methods. The overall perinatal mortality rate was about 55/1000. Within this figure there was a difference of approximately 20% of lower mortality achieved by the group of attendants who had received more training. The method of assessment did not permit accurate identification of the contribution of asphyxia to overall mortality. An individual TBA deals with comparatively few births per year and will see very few asphyxiated babies. Therefore, constant reinforcement and rehearsal of the skills is required.