Training traditional birth attendants reduces maternal mortality and morbidity
Brennan, M.
Tropical Journal of Obstetrics and Gynaecology 1(1): 44-47
1988
ISSN/ISBN: 0189-5117 PMID: 12179276 Document Number: 382926
The paper presents the maternal mortality rates in St. Mary's Hospital Urua Akpan from the period of 1979-1985 excluding (1981 Author on leave). 70% of maternal deaths were among unbooked local Annang women who lived within a radius of 15-20 miles from the hospital. They had been attended to by traditional birth attendant (TBAs) and referred too late. The maternal rate decreased from 10/1000 in 1979 to 4/1000 in 1985. The main causes of maternal death during this period include ruptured uterus, septicemia, hepatitis, hemorrhage, eclampsia, and hypertension/nephritis. A community survey (190 interviewed women) revealed that up to 50% of women still prefer to deliver at home and are attended to by TBAs. A training program for TBAs in the Local Government Area (LGA) was started in June 1983. Each course lasted 3 months in which basic instruction in hygiene, simple antenatal care, labor and its complications, and care of mother and child was given. Since starting the program, the TBAs have referred 320 patients with medical pregnancies, vacuum, and symphysiotomy. From 1983-1986, there were 38 perinatal deaths and 2 maternal deaths among the TBAs referrals. Since 1983, the maternal death rate and morbidity have fallen especially among women from the LGA; maternal mortality declined 50% among these women which account for only 30% of the total hospital births/year. Furthermore, 16,000 children have been vaccinated. The beneficial aspects of TBA training include observing the principles of hygiene, early referral of patients to hospital, encouraging village children to come for vaccinations and generally using their influence in the cultural, ritual and religious life of traditional society to become good health educators.