17th August, 2011
AMREF position on traditional birth attendants
Traditional birth attendants (TBA) have long been the main health care providers for women during childbirth in Africa. They attend the majority of childbirths in rural areas. They are often highly respected and perform cultural rituals and provide essential social support to women during childbirth.
TBA also help with initiating breastfeeding, providing information on reproductive health and nutrition, and visiting mothers during and shortly following delivery.
TBA have no training on how to recognise and respond appropriately to pregnancy complications.
For this reason, the way many attended the delivery was risky for women and their babies, leading to poor health outcomes and even death. Training TBA has been a key strategy to improving maternal and child health care in many African countries.
Despite the intensive training of TBA, recent studies have concluded that the impact of training TBAs on maternal mortality could also be counterproductive, as it would hold back the training of the necessary number of skilled practioners. This led WHO and UNICEF to recommend the use of skilled birth attendants for childbirth delivery rather than TBAs.
AMREF position
Until they are replaced by skilled birth attendants, TBAs remain the only option to many poor women. AMREF therefore advocates for their training, supervision and support in assisting deliveries.
- TBA cannot be substitutes for skilled providers, but they can contribute to the survival of mothers and new born by facilitating access to clinical services and support.
- TBA can better convey vital information to families in a culturally appropriate way
- TBA should work closely with health planners, health professionals and other members of the formal health system as a strong link between the community and the health services.
- TBA should be included in all community education and mobilisation efforts.
How AMREF responds
- Ensuring TBA are attached to a specific health facility so they can benefit from the supervision of skilled health provider
- Educating TBA on harmful cultural practices such as Female Genital Mutilation to sensitise the community
- Helping TBAs work with skilled health providers to build relationship within the community.
While AMREF always operates within national health systems’ guidelines, where health facilities are limited and skilled health providers rare, AMREF still believes that TBAs are useful and reliable partners in our maternal health outreach programme.