Academic literature on the topic 'Traditional birth attendants (TBAS)'
Create a spot-on reference in APA, MLA, Chicago, Harvard, and other styles
Consult the lists of relevant articles, books, theses, conference reports, and other scholarly sources on the topic 'Traditional birth attendants (TBAS).'
Next to every source in the list of references, there is an 'Add to bibliography' button. Press on it, and we will generate automatically the bibliographic reference to the chosen work in the citation style you need: APA, MLA, Harvard, Chicago, Vancouver, etc.
You can also download the full text of the academic publication as pdf and read online its abstract whenever available in the metadata.
Journal articles on the topic "Traditional birth attendants (TBAS)"
1
Khattab, M. S., M. Y. Khan, Y. M. Al Khaldi, and M. N. Al Gamal. "The need for traditional birth attendants -dayas- in Saudi Arabia." Eastern Mediterranean Health Journal 6, no. 1 (February 15, 2000): 13–24. http://dx.doi.org/10.26719/2000.6.1.13.
Full textAbstract:
Preferences of women living in remote areas regarding delivery place and attendant were surveyed, opinions of primary health care [PHC] doctors about traditional birth attendants’ [TBA] maternal care were assessed and training needs for TBAs were identified using questionnaires and a focus group discussion. Home deliveries and TBAs were preferred by approximately 24% and 38% of the women respectively. The fact that they were women and psychological comfort were the main reasons for preferring TBAs. TBAs disclosed many harmful practices. No PHC centre help was sought by 75% of TBAs. Lack of cooperation between PHC centres and TBAs was a concern of most of the doctors. Training and links to PHC services for TBAs are needed
2
Mbutu, Paschalia, Wanjiru Gichuhi, and Grace Nyamongo. "Traditional Birth Attendants and Childbirth in Kenya." International Journal for Innovation Education and Research 6, no. 5 (May 31, 2018): 1–18. http://dx.doi.org/10.31686/ijier.vol6.iss5.1019.
Full textAbstract:
The first objective of this research was to explore the role played by traditional birth attendants (TBAs) during pregnancy and childbirth. The second objective was to establish perspectives of pregnant women regarding the role played by TBAs during childbirth. Eight TBAs out of 12 were selected using simple random sampling technique. These 8 TBAs were drawn from the environs of 10 sampled health facilities. To calculate the sample size for the pregnant women to be interviewed about their perspectives towards TBAs from the 10 sampled health facilities , this formula was used, 1230 x 15/100=184.5 rounded up to 185. According to 2009 census, the population of women at child bearing age (15 – 49 years) was 1230 in Kitui West Sub-County (KNBS et al.; 2009). The final sample size for pregnant women was 187 as shown under the discussion on sampling techniques. An in depth individual interview guide was used to gather information from the 8 TBAs and 165 pregnant women. Unstructured interview guide was used to gather information from 22 respondents who formed focus group discussion (FGD). To make a meaning from the raw data, it was transcribed and emerging themes and patterns according the objective of the study were picked. The Chi-square test analysis showed that more than a half of the women preferred to deliver at home assisted by a TBA. (χ2=1.572; df=2; p=0.036) where p=0.05. This was confirmed by the fact that 37 percent out of 135 respondents who attended ANC clinic and 90 percent out of 30 respondents who did not attend ANC clinic delivered at home assisted by TBAs.
3
Homer, Caroline S. E., Tauaitala Lees, Pelenatete Stowers, Fulisia Aiavao, Annabel Sheehy, and Lesley Barclay. "Traditional Birth Attendants in Samoa: Integration With the Formal Health System." International Journal of Childbirth 2, no. 1 (2012): 5–11. http://dx.doi.org/10.1891/2156-5287.2.1.5.
Full textAbstract:
A traditional birth attendant (TBA) is a person who assists the mother during childbirth and who initially acquired her skills by delivering babies herself or through apprenticeship to other TBAs. In many parts of the world, TBAs continue to provide a significant proportion of maternity care during pregnancy, birth, and the postpartum period. In Samoa, TBAs are recognized part of both the formal and informal health care system. The aim of this research was to examine the contribution that TBAs made in the provision of maternity care in Samoa. A descriptive study was undertaken, and 100 TBAs who had attended more than 400 births a year were interviewed as part of a broader Safe Motherhood Needs Assessment.The findings highlighted that although TBAs can work in collaboration with individual health providers or facilities or be integrated into the health system, TBAs were often practicing autonomously within their communities, independent of collaborative links. This study showed that formal recognition and registration of TBAs would improve the recording of births and augment their partnership to the formal health care system. This formal registration process has since been implemented to improve monitoring and evaluation and assist future research with this important group.
4
Lynch, Oona, and Marc Derveeuw. "The Impact of Training and Supervision on Traditional Birth Attendants." Tropical Doctor 24, no. 3 (July 1994): 103–7. http://dx.doi.org/10.1177/004947559402400303.
Full textAbstract:
A survey of 40 trained and 40 untrained traditional birth attendants (TBAs) was done over a 3-week period in two counties in Uganda to evaluate the impact of training and supervision on TBAs. Forty womens' groups and 20 mothers were also interviewed. The result showed that the most utilized birth attendants were mothers-in-law, trained and untrained TBAs, and the pregnant woman herself. Childbirth was regarded as a normal, private event and the birth attendants were normally called when labour was well advanced or in case of complications. Trained TBAs were attending three times the number of deliveries as untrained TBAs. There was no difference in the knowledge and practices of trained and untrained TBAs, and in the performance of supervised versus unsupervised trained TBAs. All TBAs demonstrated poor knowledge and practices in the management of complications of pregnancy and labour. Reasons suggested for the poor performance included an over ambitious, inappropriate initial training, and lack of useful supervision. Overall the study concluded that there was a case for continuing with the training and supervision of TBAs provided changes were made to the selection, training and supervision processes.
5
Choguya, Naume Zorodzai. "Traditional Birth Attendants and Policy Ambivalence in Zimbabwe." Journal of Anthropology 2014 (May 7, 2014): 1–9. http://dx.doi.org/10.1155/2014/750240.
Full textAbstract:
This paper analyses the importance of the services rendered by traditional birth attendants (TBAs) to pregnant women in Zimbabwe. It argues that, though an integral part of the health system, the ambivalence in terms of policy on the part of the government leaves them in a predicament. Sociocultural values as well as tradition imbue TBAs power and authority to manage pregnancies and assist in child deliveries. On the other hand, government policies expounded through the Ministry of Health (MoH) programs and policies appear to be relegating them to the fringes of healthcare provision. However, in a country with a failing health system characterized by mass exodus of qualified personnel, availability of drugs, and understaffing of healthcare centres, among others, TBAs remain the lifeline for many women in the country. Instead of sidelining them in healthcare interventions, I argue that their integration, however, problematic and often noted to be with disastrous consequences for traditional medicine, presents the sole viable solution towards achieving MDGs 4 and 5. The government and MoH should capitalize on the availability of and standing working relations of TBAs with the grassroots for better/positive maternal health outcomes. In a country reeling with high maternal deaths, TBAs’ status and position in society make them the best intervention tools.
6
Taye, Birhan Tsegaw, Mulualem Silesh Zerihun, Tebabere Moltot Kitaw, Tesfanesh Lemma Demisse, Solomon Adanew Worku, Girma Wogie Fitie, Yeshinat Lakew Ambaw, et al. "Women’s traditional birth attendant utilization at birth and its associated factors in Angolella Tara, Ethiopia." PLOS ONE 17, no. 11 (November 11, 2022): e0277504. http://dx.doi.org/10.1371/journal.pone.0277504.
Full textAbstract:
Background In developing countries, home delivery without a skilled birth attendant is a common practice. It has been evidenced that unattended birth is linked with serious life-threatening complications for both the women and the newborn. Institutional delivery with a skilled birth assistance could reduce 20–30% of neonatal mortality. This study aimed to assess traditional birth attendants’ (TBAs) utilization and associated factors for women who gave birth in the last two years in Angolella Tara District, Ethiopia. Methods A community-based cross-sectional study was employed among 416 women who gave birth in the last two years at rural Angolella Tara District. Study participants were recruited by using a simple random sampling technique. Data were collected using a structured, pretested, and interviewer-administered questionnaire. Epi Data 4.6 and SPSS version 25 were used for data entry and analysis, respectively. A multivariable logistic regression model was fitted to identify factors associated with women’s utilization of traditional birth attendants. The level of significance in the last model was determined at a p-value of <0.05. Result Overall, 131 (31.5%) participants were used traditional birth attendants in their recent birth. Unmarried marital status (AOR 2.63; 95% CI: 1.16, 5.97), age at first marriage (AOR 2.31; 95%CI: 1.30, 4.09), time to reach health facility (AOR = 3.46; 95% CI: 1.94, 6.17), know danger sign of pregnancy and childbirth (AOR = 5.59, 95% CI; 2.89, 10.81), positive attitude towards traditional birth attendants (AOR = 2.56 95% CI; 1.21,5.52), had antenatal care follow-up (AOR: 0.11 95% CI 0.058, 0.21), and listening radio (AOR = 0.43; 95% CI: 0.18, 0.99) were significantly associated factors with the use of traditional birth attendants. Conclusion Nearly one-third of women used traditional birth attendant services for their recent birth. TBAs availability and accessibility in the community, and respect for culture and tradition, problems regarding infrastructure, delay or unavailability of ambulance upon call, and some participants knowing only TBAs for birth assistance were reasons for preference of TBAs. Therefore, effort should be made by care providers and policymakers to ensure that modern health care services are accessible for women in a friendly and culturally sensitive manner. In addition, advocacy through mass media about the importance of maternal health service utilization, particularly antenatal care would be important.
7
Roberts, Lisa R., and Barbara A. Anderson. "Enhancing Traditional Birth Attendant Training in Guatemala." International Journal of Childbirth 11, no. 1 (February 18, 2021): 27–36. http://dx.doi.org/10.1891/ijcbirth-d-20-00028.
Full textAbstract:
BACKGROUNDThis article describes the follow-up study to Simulation Learning Among Low Literacy Guatemalan Traditional Birth Attendants, published in the International Journal of Childbirth in 2017. This current study had two purposes: (a) to implement and evaluate the use of enhanced training modalities (active-learning strategies and use of technology in a remote area), and (b) to pilot training-of-trainer (ToT) methods. The current study builds upon the previous study in which we conducted and evaluated a simulation-based training among low-literacy Guatemala traditional birth attendants (TBAs).MATERIALS AND METHODSIn the current study, we conducted a focus group with experienced TBAs (n = 8) to elicit concepts and issues important to address in the training. The 60-hour training designed for low-resource settings, was enhanced with active-learning strategies, technology, and ToT modules. We assessed pre–posttest knowledge and attitudes by paper-pencil format, and pre–post skills by demonstration using simulation.RESULTSTraining participants (N = 31) included the eight experienced TBAs from the focus group. Knowledge, skills, and attitudes all improved, with statistical significance achieved in many parameters. Evaluation of the training was positive and enhancement strategies were noted as particularly helpful. Two participants participated in the additional ToT modules and are now collaborating to provide short educational programs to other TBAs in their regions.CONCLUSIONTraining enhancement strategies have the potential to increase safe practice among TBAs where skilled birth attendants are lacking. Adding ToT modules enhances sustainability and exemplifies the importance of locally prepared trainers in a time when global interaction is severely limited.
8
Surtimanah, Tuti, and Yanti Herawati. "Traditional Birth Attendants (TBAs) Positioning on Strengthening Partnership with Midwives." Jurnal Kesehatan Masyarakat 13, no. 1 (July 28, 2017): 77–87. http://dx.doi.org/10.15294/kemas.v13i1.7452.
Full textAbstract:
Background of this research was the still high number of infant mortality and high use of Traditional Birth Attendants (TBAs). The This study aims aimed to determine TBAs positioning on the effort of strengthening partnership with midwives. A number of pregnant women, TBAs, and midwives become became informants, through in-depth interviews and focus group discussions. The results showed positioning TBAs still needed with different roles but side by side with midwife role, used by primi and multi pregnant women before and during pregnancy, during and after birth. The requirement forrequirement for TBAs was derived from parents as a cultural heritage, whereas the requirement for midwife obtained was from formal and non- formal information. The TBAs services toward maintain family health care including include cultural events. The midwife is givingserved professional servicescare. The partnership includes clients registration, motivation, abnormalities early detection. There has had been an unwritten financing unwritten agreement. The TBAs midwife partnership needs to be strengthened through legislation and , communication to diverse audiences in order to form the right positioning.
9
Choguya, Naume Zorodzai. "Traditional and Skilled Birth Attendants in Zimbabwe: A Situational Analysis and Some Policy Considerations." Journal of Anthropology 2015 (May 18, 2015): 1–11. http://dx.doi.org/10.1155/2015/215909.
Full textAbstract:
The paper focuses on the situational analysis of traditional birth attendants (TBAs) and skilled birth attendants (SBAs) in Zimbabwe. Against a background of a frail health care system, characterised by a shortage in skilled professionals, increased cost of medical care, and geographic and economic inaccessibility of health care centres among others, TBAs have remained a life-line for especially many rural women in maternal health care provision. Moreover, TBAs have also found their way into the urban areas of Zimbabwe. The shift in international policy and health funding toward skilled birth attendants (i.e., an accredited health professional) has materialized into concerted government efforts to increase numbers of both midwifery training institutions and midwives themselves. The call for SBAs, though a worthy ideal, is out of touch with the lived realities of pregnant women in low resource settings such as Zimbabwe. The study is concerned with situational analysis of TBAs and SBAs in maternal health care service provision in Zimbabwe analysing and evaluating policy considerations.
10
Roberts, Lisa R., and Barbara A. Anderson. "Simulation Learning Among Low Literacy Guatemalan Traditional Birth Attendants." International Journal of Childbirth 7, no. 2 (2017): 67–76. http://dx.doi.org/10.1891/2156-5287.7.2.67.
Full textAbstract:
Guatemalan maternal and infant mortality rates remain high, particularly among indigenous populations. In remote areas, traditional birth attendants (TBAs), without formal midwifery education, are frequently the only maternal care providers. We conducted a mixed methods study to evaluate knowledge, skills, and attitudes of 26 TBAs in western Guatemala. The purposes of this study were to evaluate the efficacy of a community-based midwifery training program and to determine how the knowledge, skills, and attitudes of TBAs influence the care provided to indigenous mothers and infants. Themes from 5 key informant interviews included survival of mother and baby, facilitating referrals, and community pressure not to refer. We offered a 2-week simulation-based training designed for low resource settings. Participants completed pre- and posttests and demonstrated midwifery skills. Knowledge scores and objectively measured skills improved significantly. Attitude outcomes included increased endorsement regarding importance of pre- and postnatal visits, recognizing risk/complications, and partnering with medical providers. Potential effects discussed include safe TBA practice, training value, and intent to disseminate learnings in their communities.
Dissertations / Theses on the topic "Traditional birth attendants (TBAS)"
1
Saravanan, Sheela. "Training of traditional birth attendants : an examination of the influence of biomedical frameworks of knowledge on local birthing practices in India." Thesis, Queensland University of Technology, 2008. https://eprints.qut.edu.au/19234/1/Sheela_Saravanan_Thesis.pdf.
Full textAbstract:
Pregnancy and childbirth complications are a leading cause of death and disability among women of reproductive age in developing countries. Worldwide data shows that, by choice or out of necessity, 60 percent of births in the developing world occur outside a health institution and 47 percent are assisted by Traditional Birth Attendants (TBAs), family members, or without any assistance at all. This thesis argues that TBAs in India have the capacity to disseminate knowledge of beneficial maternal practices to the community. Since the 1970s the training of TBAs has been one of the primary single interventions encouraged by World Health Organisation (WHO) to address maternal mortality. However, since the 1990s international funding for TBAs has been reduced and the emphasis has shifted to providing skilled birth attendants for all births due to evidence that the maternal mortality rate (MMR) in developing countries had not reduced. Researchers have observed that the shift in policy has taken place without adequate evidence of training (in)effectiveness and without an alternative policy in place. This thesis argues further that two main types of birthing knowledge co-exist in India; western biomedicine and traditional knowledge. Feminist, anthropological, and midwifery theorists contend that when two knowledge paradigms exist, western knowledge tends to dominate and claim authority over local ways of knowing. The thesis used such theories, and quantitative and qualitative methods, to assess whether the local TBA training programmes in Ahmednagar District in India have been successful in disseminating biomedical knowledge in relation to the birthing practices of local TBAs and in incorporating local knowledge into the training. The data revealed that some biomedical knowledge had been successfully disseminated and that some traditional practices continue to be practiced in the community. There is a top-down, one-sided imposition of biomedical knowledge on TBAs in the training programme but, at the local level, TBAs and mothers sometimes follow the training instructions and sometime do not, preferring to adapt to the local perceptions and preferences of their community. The thesis reveals the significance of TBA training in the district but queries the effectiveness of not including local TBA practices into the training programmes, arguing this demonstrates the hierarchical authority of biomedicine over local traditional practices. The thesis highlights the significance of community awareness that accompanies TBA training and makes recommendations in order to enhance training outcomes.
2
Saravanan, Sheela. "Training of traditional birth attendants : an examination of the influence of biomedical frameworks of knowledge on local birthing practices in India." Queensland University of Technology, 2008. http://eprints.qut.edu.au/19234/.
Full textAbstract:
Pregnancy and childbirth complications are a leading cause of death and disability among women of reproductive age in developing countries. Worldwide data shows that, by choice or out of necessity, 60 percent of births in the developing world occur outside a health institution and 47 percent are assisted by Traditional Birth Attendants (TBAs), family members, or without any assistance at all. This thesis argues that TBAs in India have the capacity to disseminate knowledge of beneficial maternal practices to the community. Since the 1970s the training of TBAs has been one of the primary single interventions encouraged by World Health Organisation (WHO) to address maternal mortality. However, since the 1990s international funding for TBAs has been reduced and the emphasis has shifted to providing skilled birth attendants for all births due to evidence that the maternal mortality rate (MMR) in developing countries had not reduced. Researchers have observed that the shift in policy has taken place without adequate evidence of training (in)effectiveness and without an alternative policy in place. This thesis argues further that two main types of birthing knowledge co-exist in India; western biomedicine and traditional knowledge. Feminist, anthropological, and midwifery theorists contend that when two knowledge paradigms exist, western knowledge tends to dominate and claim authority over local ways of knowing. The thesis used such theories, and quantitative and qualitative methods, to assess whether the local TBA training programmes in Ahmednagar District in India have been successful in disseminating biomedical knowledge in relation to the birthing practices of local TBAs and in incorporating local knowledge into the training. The data revealed that some biomedical knowledge had been successfully disseminated and that some traditional practices continue to be practiced in the community. There is a top-down, one-sided imposition of biomedical knowledge on TBAs in the training programme but, at the local level, TBAs and mothers sometimes follow the training instructions and sometime do not, preferring to adapt to the local perceptions and preferences of their community. The thesis reveals the significance of TBA training in the district but queries the effectiveness of not including local TBA practices into the training programmes, arguing this demonstrates the hierarchical authority of biomedicine over local traditional practices. The thesis highlights the significance of community awareness that accompanies TBA training and makes recommendations in order to enhance training outcomes.
3
Graham, Sally. "Traditional birth attendants in Karamoja, Uganda." Thesis, London South Bank University, 1999. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.298024.
Full text
4
Mambwe, Esther, and esther membwe@dealin edu au. "Teaching Zambian traditional birth attendants to monitor growth of infants." Deakin University. School of Nutrition and Public Health, 1996. http://tux.lib.deakin.edu.au./adt-VDU/public/adt-VDU20061207.151734.
Full textAbstract:
The high infant mortality in Zambia is largely attributable to malnutrition. It is exacerbated by the inability of mothers to recognise threats to nutritional status and take corrective action. Advice in Health Centres is often inaccessible to mothers. The Traditional Birth Attendants (TBAs) work with pregnant women in local communities, and the purpose of this study was to develop and implement an educationprogram in growth monitoring and nutrition for the TBAs and then to evaluate its effects. Twenty five TBAs from two peri-urban areas of Kitwe were enrolled in this pilot study and eighteen completed the program.
The researcher developed and taught a program to the TBAs over ten days. A pretest was given before the teaching program to enable the researcher to obtain information about the knowledge and skills of the TBAs. Following the teaching program the TBAs were re-tested, with the same questionnaire. Focus groups were conducted to enable the TBA to provide information on the teaching materials and the education program. The TBAs then returned to their communities and put into practice the skills and knowledge they had learned for six months. Their practice was monitored by a trained Public Health Nurse. The researcher also surveyed 38 pregnant women about their knowledge of growth monitoring and nutrition before the TBAs went into the field to work with their local communities. The same questionnaire used with the pregnant women was administered to 38 new mothers with children aged 0 to 6 months to gain information of their knowledge and skills following the work of the TBAs.
The program was evaluated by assessing the extent to which TBAs knowledge and skills were increased, the knowledge and understanding of a selection of their clients and the rates of malnutrition of infants in the area under study.
The results from the research clearly indicated that the teaching program on growth monitoring and nutrition given to the selected group of TBAs had a positive effect on their knowledge and skills. It was found that the teaching developed their knowledge, practical skills, evaluative skills. That they were able to give infants mothers sound advice regarding their childrens nutrition was revealed by the mothers increased knowledge and the decrease in numbers of malnourished children in the study areas at the conclusion of the research.
The major outcomes from the study are: that Zambian TBAs can be taught to carry out an expanded role; field experience is a key factor in the teaching program; making advice available in local communities is important; and preliminary data on the Zambian experience were generated.
Recommendations are: The pilot program should be expanded with continuing support from the Health Department. Similar educational programs should be introduced into other areas of Zambia with support from the Ministry of Health.
That in administering a teaching program: Sufficient time must be allocated to practical work to allow poorly educated women to attain the basic skills needed to master the complex skills required to competently reduce faltering in their communities. The teaching materials to illustrate nutritional principles for feeding programs must be developed to suite locally available foods and conditions. Methods of teaching should suit the local area, for example, using what facilities are locally available. The timing of the teaching program should be suitable for the TBAs to attend. This may vary from area to area, for example it may be necessary to avoid times traditionally given to fetching water or working in the fields. For similar reasons, the venue for the teaching program should be suitable to the TBAs. The teachers should go into the TBAs community rather than causing disruption of the TBAs day by expecting them to go to the teacher.
Data should be collected from a larger group of TBAs and clients to enable sophisticated statistical analysis to complement data from this pilot program.
The TBAs should be given recognition for their work and achievement. This is something which they asked for. They do not ask for payment, rather acknowledgment through regular follow up and approbation.
5
Hirsi, Alasa Osman. "Factors influencing the choice of place of child delivery among women in Garissa district, Kenya." University of the Western Cape, 2011. http://hdl.handle.net/11394/5288.
Full textAbstract:
Magister Public Health - MPHAlthough the Kenyan government implemented safe motherhood programme two decades ago, available data indicate that prevalence of home delivery is still high among women in Garissa District. The aim of this thesis was to investigate the factors influencing the choice of place of childbirth. Methodology: A descriptive cross-sectional study was carried out among 224 women who delivered babies two years prior to December 2010. Using a statcalc program in Epi Info 3.3.2, with expected frequency of home delivery at 83% +5% and a 95% confidence level, the calculated sample size was 215. Furthermore, with a 95% response rate the adjusted minimum sample size was 226.There were two none-responses hence 224 women were interviewed. Stratified sampling was used. Data were collected using pre-tested structured questionnaires and analyzed using SPSS. Descriptive, bivariate and multivariate analysis was performed. A binary logistic regression analysis using the Enter method was performed to determine independent predictors for use or non-use of healthcare services for childbirth. The threshold for statistical significance was set at 0.05. Results: The result was presented in text and tables. The study found 67% (n=224) women delivered at home and 33% delivered in hospital. The study found low level of education, poverty, none-attendance of ANC, distance, cost of services, poor quality services, negative attitude towards midwives, experience of previous obstetric complications and decision-making to be significant predictors in home delivery at the bivariate level (p<0.05). The study did not find relationship between age, marital status, religion and place of childbirth (p>0.05). At multivariate level, the following variables were still found to be significant predictors of home delivery: no education OR=8.36 (95% CI; 4.12-17.17), no occupation OR=1.43(95% CI; 1.08–5.49) experience of obstetric complications OR=1.38 (95% CI; 1.15-2.12), none-attendance of antenatal clinic OR=1.11 (95% CI; 1.03–1.51), Rude midwives OR=5.60 (95% CI; 2.66-11.96). Conclusions: high prevalence of home delivery was noted due to lack of education, poverty and inaccessible maternity services hence the need to empower women in education and economy to enhance hospital delivery.
6
Aderinwale, Adetayo Seun. "Well-educated middle class women and their preference for traditional rather than skilled birth attendants in Lagos Nigeria a qualitative study." University of the Western Cape, 2021. http://hdl.handle.net/11394/8442.
Full textAbstract:
Master of Public Health - MPHBackground:Theoutcomeofpregnanciesinmanyinstancesislargelypredicatedon availabilityofSkilledBirthAttendants(SBAs).Despitethisphenomenon,illiteracyand financialdisadvantagehavebeenvariouslycitedastwinfactorspromotingtheinterest andpatronageofTraditionalBirthAttendants(TBAs)bywomenfolk.Itistherefore expected thatwomenhavingtertiarylevelofeducationandpossessing adequate economic resources would naturally prefer to use the SBAs.However,these http://etd.uwc.ac.za/ 9 observationshavenotsignificantlyreflected therealityin thechoiceofmaternal healthcareprovidersinNigeriaandthecityofLagosinparticular.Yet,accessto maternalservicesoftheSBAshasbeenwidelyacceptedasoneoftheleadingwaysof loweringmaternalmortality.Therefore,inordertoimprovethepatronageofSBAsand correspondinglylowermaternaldeathrates,itbecomesimperativetounderstandthe rationalebehindthepreferencefortheTBAs’usebywomenwhoarenotordinarily expectedtodosobyvirtueoftheirhighlevelofeducationandgoodfinancialcapacity. Aim:Theaim ofthisstudywastoexploreandunderstandtheexperiences,perception and beliefsystems influencing well-educated,middle income women and their reasoningfortheuseofTraditionalBirthAttendantsratherthanSkilledBirthAttendants fordeliveryservicesinLagos,Nigeria. Methodology:ThisisaqualitativestudyconductedinAlimoshoLocalGovernmentArea ofLagosinNigeria.Tenwomenwithtertiarylevelofeducationandbelongingtomiddle incomeeconomiccategorieswereenrolledasparticipants.Inaddition,itinvolved3 FocusGroupDiscussionscomprising7TraditionalBirthAttendantspergroup. Results:Behaviouraland attitudinalshortcomings by the SBAs;misconceptions regardingsurgicaldeliverybywomen;bureaucraticdelaysandbottlenecksexperienced attheSBAs’centres;thebeliefbythewomenthatpregnancyisasacredandspiritual eventwhichonlytheTBAshaveabilitytomanage;women’sconfidenceintheTBAsas havingbettercapacitytomanagecertaincoexistingmedicalconditionsinpregnancy; andmisinformationonmanagementmodalitiesforcertainconditionslikeinfertilityand fibroidallcombinetoinfluencepreferenceforutilizationofTBAsbywell-educated, middleincomewomeninthestudyarea.
7
Uny, Isabelle. "Weighing the options for delivery care in rural Malawi : community actors' perceptions of the 2007 policy guidelines and redefined traditional birth attendants' roles." Thesis, Queen Margaret University, 2017. https://eresearch.qmu.ac.uk/handle/20.500.12289/7469.
Full textAbstract:
Despite significant recent improvements, maternal mortality remains high in Malawi. To address this, the Government prioritised strategies promoting skilled birth attendance. However, in a country where 80% of the population resides in rural areas, there are tremendous barriers to institutional deliveries. Historically rural women have been supported in childbirth by Traditional Birth Attendants (TBAs), and by skilled birth attendants (SBAs) at the health facility. In the past, TBAs were trained to help bridge the gaps in provision and accessibility of care but in the 1990’s, the WHO recommended halting their training because it was perceived as ineffective for maternal mortality reduction. In 2007, the Government of Malawi issued Community Guidelines to promote skilled birth attendance and banned TBA utilization for routine deliveries. This grounded theory qualitative study used interviews and focus groups to explore community actors’ perceptions of the 2007 Policy Guidelines and their implementation, and how the Policy affected the decisions and actions of rural women regarding their delivery care. Findings from this study indicate that although all actors may agree that delivering at facilities is safest when complications occur, this does not necessarily ensure their compliance. Women, men and TBAs particularly, perceived the Policy as prescriptive. Furthermore, the implementation of the policy aggravated some of the barriers women already faced. Issues of disrespectful and neglectful care at facilities also partly led women towards non-compliance. Furthermore, a view from the ground demonstrated that the Policy had led to a rupture of linkages between TBAs and SBAs, which have had a detrimental effect on the continuum of care. This study helps fill an important gap in research concerning maternal health policy implementation analysis in LICs, by focusing on the perceptions of those at the receiving end of policy change, and on their needs, and aspirations.
8
VIEIRA, Cláudia Susana de Lima. "International experiences to increase the use of skilled attendants in contexts where traditional bhirth attends are the primary provider of child birth care: a systematic review." Master's thesis, Instituto de Higiene e Medicina Tropical, 2011. http://hdl.handle.net/10362/51210.
Full textAbstract:
Objectivo: A presente revisão sistemática da literatura pretende identificar e compreender melhor, as intervenções implementadas em diversos países, e os respectivos resultados, para aumentar o uso de provedores qualificados, em contextos onde as parteiras tradicionais são os principais provedores de cuidado no parto.
Metodologia: Foram pesquisadas 87 bases de dados electrónicas para a obtenção de referências sobre parteiras tradicionais e obstetrícia. Foram também contactados peritos para a obtenção de mais referências neste tópico. Não foi feita qualquer distinção entre países de baixo, médio ou alto rendimento, ou ano ou estado da publicação. Foram utilizados métodos de revisão sistemática narrativa.
Resultados: A pesquisa electrónica resultou na obtenção de 16.814 referências em 26 das 87 bases de dados pesquisadas. Após a eliminação de duplicados e da aplicação dos critérios de elegibilidade a todas as referências, tanto as obtidas das bases de dados electrónicas, como as dos peritos, 19 referências foram incluídas para extracção sistemática de dados, e 91 foram inventariadas por tipo de intervenção em cada país. As referências obtidas reflectem as experiências de 38 países.
A maioria das intervenções descritas nas 19 referências às quais se fez extracção sistemática de dados foram: melhoria no acesso aos serviços através da eliminação de barreiras geográficas e/ou económicas (n= 10) e desenvolvimento e/ou implantação de recursos humanos (n= 6). Para além destas, 2 referências eram relativas a intervenções de sensibilização da comunidade, e 1 era sobre a adaptação cultural dos partos institucionais.
Conclusão: A maioria das referências às quais se fez extracção sistemática de dados relataram estudos que foram considerados de baixa qualidade, com uma variação considerável na qualidade de informação proporcionada. Uma vez que a maioria dos estudos não usou no seu desenho uma distribuição aleatória, foi difícil atribuir com confiança resultados positivos a uma intervenção específica. Contudo, os estudos mostraram resultados positivos para o aumento do uso de atendimento/provedores qualificados e melhorias nos resultados de mortalidade materna, com uma concomitante redução no uso de parteiras tradicionais. No entanto, muitos estudos apontaram uma persistência de desigualdades, e mais atenção precisa de ser dada aos custos de transporte e preferências culturais.
As referências analisadas nesta revisão sistemática da literatura apresentam um segmento de tempo/intervenção e local, e seria útil elaborar uma análise aprofundada dos países, para detectar o impacto destas intervenções na redução de mortes maternas.Objective: The current systematic review intends to identify and better understand the interventions implemented in different countries to increase the use of skilled attendants in contexts where traditional birth attendants are the primary provider of childbirth care, and to summarize the outcomes of the different interventions. Methods: Eighty-seven electronic databases were searched for references on traditional birth attendants and midwifery. Experts in the field were also contacted to request documents related to the topic. No distinction was made between low, middle and high-income countries or publication year or status. Standard narrative systematic review methods were used. Findings: The electronic searches yielded a total of 16,814 references from 26 of the 87 databases. After elimination of dupplicates and the application of the eligibility criteria to all references - from the electronic searches and the experts in the field - 19 references were included for systematic data extraction and 91 references for inventory of the type of intervention and country. These references were from a total of 38 countries. Of the 19 references from which data was systematically extracted, the majority of interventions described were: improvement of access to services by removing geographical and/or financial barriers (n= 10) and human resources development and/or deployment (n= 6). Following these, 2 references were about a community advocacy intervention and 1 reference was about cultural adaptation of institutional childbirths. Conclusion: The majority of the included references for systematic data extraction reported studies which were considered of low quality with considerable variation in the quality of reporting. Since most studies did not use random allocation in their design it was difficult to confidently attribute positive outcomes to an individual intervention itself. Nonetheless, the studies reviewed showed positive results for increased use of skilled attendance/attendants and improved maternal mortality outcomes, with a concomitant reduction in the use of traditional birth attendants. However many studies noted that inequities persist and more attention needs to be given to transport costs and cultural preferences. The references analysed in this systematic review present a snapshot of a time/intervention and place and it would be useful to produce in depth country profiles to see the impact of these interventions on maternal deaths reduction.
9
Singal, Robert L. "The role of traditional birth attendants in the prevention of mother to child transmission: a case study of the New Community Health Worker National Strategy of Zambia." Thesis, Boston University, 2013. https://hdl.handle.net/2144/12849.
Full textAbstract:
Thesis (Dr.P.H)--Boston University
PLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis or dissertation. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at open-help@bu.edu. Thank you.Background The Ministry of Health in Zambia is implementing a National Community Health Worker Strategy to improve health care access using a new cadre of community health assistants (CHAs). The strategy does not include traditional birth attendants (TBAs), an existing health care resource in the community. This case study examined how TBAs can work with CHAs to provide prevention of mother-to-child transmission (PMTCT) services to pregnant women and infants in rural areas within this new health worker strategy. Methods Using the case study methodology, this study analyzed multiple sources of data including published and unpublished literature, program documents and key informant interviews. Thirteen semi-structured interviews were conducted with policy makers and community field workers involved with TBAs and community health workers providing PMTCT services in rural Zambia. Methodological triangulation was used to synthesize information and compare themes across different sources to gather various perspectives and provide additional insights into the topic. Results In the absence of trained facility-based health care workers, TBAs often provide antenatal and delivery services. Acknowledging the limited provision of care for pregnant women in the CHA Strategy, respondents pointed to the potential role of CHAs in assisting with deliveries. Emphasis was placed on the importance of TBAs to reduce barriers between the home and the formal health system. TBAs and CHAs have complementary skills that can be used in partnership to provide PMTCT services. Conclusions With standardized trainings, TBAs can play a supportive role in providing PMTCT services within the new community health structure. TBAs and CHAs can assist with deliveries and provide PMTCT services at the health facility and at home. TBAs can accompany CHAs to navigate family and gender dynamics and provide home-based adherence, breastfeeding education and support, and referrals. A new incentives model for TBAs has the potential to increase facility births and engage the volunteer cadre in playing a supportive role to the CHAs. This task-shifting and sharing model, using TBAs and CHAs, can improve maternal health services by strengthening the link between the community and the facility and integrating, rather than excluding the traditional health care system.
10
Mathole, Thubelihle. "Whose Knowledge Counts? : A Study of Providers and Users of Antenatal Care in Rural Zimbabwe." Doctoral thesis, Uppsala : Acta Universitatis Upsaliensis, 2005. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-6251.
Full textBooks on the topic "Traditional birth attendants (TBAS)"
1
Hossain, M. Akhter. Role of trained traditional birth attendants (TBAs) in safe delivery practices in rural Bangladesh. Dhaka: National Institute of Population Research and Training, 1989.
Find full text
2
Townsend, Patricia K. Traditional birth attendants in Papua New Guinea: An interim report. Boroko, Papua New Guinea: Prepared [i.e. published] by the Papua New Guinea Institute of Applied Social and Economic Research for UNICEF, 1987.
Find full text
3
Chiwere, Nissia Joseph. An annotated bibliography of family planning, child spacing, and traditional birth attendants. Zomba: University of Malawi, Chancellor College, 1987.
Find full text
4
Yousuf, Jemal. Exploring the role of trained traditional birth attendants in Afar, Ethiopia. Nairobi, Kenya: African Medical and Research Foundation, 2010.
Find full text
5
Midwives without training: Practices and beliefs of traditional birth attendants in Africa, Asia, and Latin America. Assen, the Netherlands: Van Gorcum, 1994.
Find full text
6
1947-, Miller Suellen, ed. A book for midwives: A manual for traditional birth attendants and community midwives. Palo Alto, CA: Hesperian Foundation, 1995.
Find full text
7
Klein, Susan. A book for midwives: A manual for traditional birth attendants and community midwives. Edited by Miller Suellen 1947-. 2nd ed. Palo Alto, CA: Hesperian Foundation, 1998.
Find full text
8
Klein, Susan. A book for midwives: A handbook for community midwives and traditional birth attendants. Edited by Miller Suellen 1947-. London: Macmillan, 1996.
Find full text
9
Sandy, Niemann, ed. A book for midwives: A manual for traditional birth attendants and community midwives. London: Macmillan Education, 1999.
Find full text
10
University of Malawi. Centre for Social Research, ed. The effectiveness of traditional birth attendants in reducing maternal mortality and morbidity in Malawi. Zomba, Malawi]: University of Malawi, Centre for Social Research, 2004.
Find full textBook chapters on the topic "Traditional birth attendants (TBAS)"
1
MacDonald, Margaret E. "The Place of Traditional Birth Attendants in Global Maternal Health: Policy Retreat, Ambivalence and Return." In Global Maternal and Child Health, 95–115. Cham: Springer International Publishing, 2022. http://dx.doi.org/10.1007/978-3-030-84514-8_6.
Full textAbstract:
AbstractIn this chapter, I tell the story of the waxing and waning of the status of the traditional birth attendant (TBA) in global maternal health policy from the launch of the Safe Motherhood Initiative in 1987 to the present. Once promoted as part of the solution to reducing maternal mortality, the training and integration of TBAs into formal healthcare systems in the global south was deemed a failure and side-lined in the late 1990s in favour of ‘a skilled attendant at every birth’. This shift in policy has been one of the core debates in the history of the global maternal health movement and TBAs continue to be regarded with deep ambivalence by many health providers, researchers and policymakers at the national and global levels. In this chapter, I take a critical global heath perspective that scrutinises the knowledge, policy and practice of global health in order to make visible the broader social, cultural and political context of its making. In this chapter, I offer a series of critiques of global maternal health policy regarding TBAs: one, that the evidence cited to underpin the policy shift was weak and inconclusive; two, that the original TBA component itself was flawed; three, that the political and economic context of the first decade of the SMI was not taken into account to explain the failure of TBAs to reduce maternal mortality; and four, that the reorganisation of the Safe Motherhood movement at the global level demanded a new humanitarian logic that had no room for the figure of the traditional birth attendant. I close the chapter by looking at the return of TBAs in global level policy, which, I argue, is bolstered by a growing evidence base, and also by the trends towards ‘self-care’ and point-of-use technologies in global health.
2
Magrath, Priscilla. "Regulating Midwives: Foreclosing Alternatives in the Policymaking Process in West Java, Indonesia." In Global Maternal and Child Health, 139–58. Cham: Springer International Publishing, 2022. http://dx.doi.org/10.1007/978-3-030-84514-8_8.
Full textAbstract:
AbstractPromotion of “skilled birth attendants” (SBAs) in global maternal health policy has prompted a range of policy responses to “traditional birth attendants” (TBAs). In Indonesia the response has been to develop a national policy of partnership between SBAs (bidan) and TBAs (dukun bayi). This policy aims to ensure the presence of an SBA at every birth yet offers a role for TBAs. In this chapter I examine the development of a district regulation on partnership, promoted within the context of decentralization policies enacted in Indonesia from 1999. The district regulation aimed to strengthen the national policy in a location in West Java where TBAs remain popular. Drawing on 10 months of fieldwork from 2012 to 2013 at a district health office and on observations of its outreach programs, I elucidate how the regulation on partnership was promoted through the policy entrepreneurship of certain key figures in the district health office. They argued that the partnership regulation was the fastest means to improve maternal health. But casting a spotlight on the relationship between SBAs and TBAs diverted attention away from other health system challenges including under-resourced medical facilities and a weak referral system. Three contexts played into this process of bringing the partnership issue to the fore: global policies promoting SBAs and sidelining TBAs; pressure to achieve the Millennium Development Goal (MDG) on maternal mortality; and the limited financial power and decision space afforded to districts under decentralization in Indonesia. In this context, the regulation offered a viable path for demonstrating commitment to improving maternal health outcomes, yet one that failed to address broader constraints in the health system that contribute to persistent high maternal mortality rates.
3
Williams, Sarah A., and Janice Boddy. "Midwifery and traditional birth attendants in transnational perspective." In The Routledge Handbook of Religion, Medicine, and Health, 349–62. London: Routledge, 2021. http://dx.doi.org/10.4324/9781315207964-28.
Full text
4
Olaore, Augusta Y., Nkiruka Rita Ezeokoli, and Vickie B. Ogunlade. "Community Traditional Birth Attendants and Cultural Birthing Practices in Nigeria." In Community Practice and Social Development in Social Work, 107–26. Singapore: Springer Singapore, 2020. http://dx.doi.org/10.1007/978-981-13-6969-8_5.
Full text
5
Olaore, Augusta Y., Nkiruka Rita Ezeokoli, and Vickie B. Ogunlade. "Community Traditional Birth Attendants and Cultural Birthing Practices in Nigeria." In Community Practice and Social Development in Social Work, 1–20. Singapore: Springer Singapore, 2019. http://dx.doi.org/10.1007/978-981-13-1542-8_5-1.
Full text
6
Maraesa, Aminata. "Managing Maternal Mortality: On-the-Ground Practices of Traditional Birth Attendants in Southern Belize." In Global Maternal and Child Health, 433–49. Cham: Springer International Publishing, 2018. http://dx.doi.org/10.1007/978-3-319-71538-4_22.
Full text
7
Zinyemba, Lizzy. "The Role of Traditional and Spiritual Birth Attendants in Maternal Health Care amongst Tonga Women of Binga." In Tonga Livelihoods in Rural Zimbabwe, 131–44. London: Routledge, 2022. http://dx.doi.org/10.4324/9781003278580-11.
Full text
8
Aliyu, Ruqayyah Yusuf. "Evil Spirits and Martyrdom as Perceptions of Pre-eclampsia Among Traditional Birth Attendants in Kano, North-West Nigeria." In Health Communication and Disease in Africa, 231–46. Singapore: Springer Singapore, 2021. http://dx.doi.org/10.1007/978-981-16-2546-6_10.
Full text
9
Petitet, Pascale Hancart. "Training Birth Attendants in India." In Childbirth in South Asia, 96–118. Oxford University Press, 2021. http://dx.doi.org/10.1093/oso/9780190130718.003.0004.
Full textAbstract:
This chapter documents the local and global processes of construction, legitimization and delegitimization, and the political uses of the knowledge of traditional birth attendants—TBAs. Based on four years’ ethnographical investigation in Tamil Nadu, this chapter discusses the issue from various points of view. It looks at the debates of actors involved in the national and international public health agendas, Indian movements promoting ‘Natural Childbirth’, and movements in favour of the preservation of traditional systems of medicine. TBAs are variously perceived as wicked mothers whose archaic practices must be controlled, the archetypal ambassadors of traditional knowledge, or as relevant actors bringing together ideal elements of any development activity—locality, community, and low cost. This careful reading of the contemporary social representations of TBAs and of their role reconfigurations offers a lens to examine authoritative knowledge’s social forms, practices, and paradoxes.
10
Oyesomi, Kehinde Opeyemi, Toluwanimi Onakoya, Kevin Onyenankeya, and Ayobami Busari. "Indigenous Communication's Role in Traditional Birth Attendants in Maternal Health Practices." In Emerging Trends in Indigenous Language Media, Communication, Gender, and Health, 1–18. IGI Global, 2020. http://dx.doi.org/10.4018/978-1-7998-2091-8.ch001.
Full textAbstract:
Indigenous communication is an indispensable medium of communication in the socio-cultural tradition of Africans. These systems have been used to promote co-operation, mobilization, and participation among African people. This chapter takes into account indigenous communication roles of traditional birth attendants in maternal wellbeing and maternal health practices during pregnancy and childbirth in both Nigerian and South African communities. The significant motivation behind the examination is to assess the indigenous communication role of traditional birth attendants in maternal health practices in the two nations through empirical studies. After careful review of the studies, it is shown and discovered that TBAs in both Nigeria and South Africa assist pregnant women based on their religious or traditional beliefs. The researchers therefore recommend that health professionals should train TBAs in modern maternal health practices. This will go a long way to help them know their restrictions and possibly refer mothers and their children for emergency services and attention as needed.
Conference papers on the topic "Traditional birth attendants (TBAS)"
1
Kamboj, Sukhjeet, Mabel C. Ezeonwu, Jennifer Hoock, and Suryabir Kamboj. "Study on the Knowledge Gap in Training Organized for Traditional Birth Attendants (TBAs) in Rural Guatemala and the Way for Improvement." In Global Public Health Conference. The International Institute of Knowledge Management - (TIIKM), 2020. http://dx.doi.org/10.17501/26138417.2020.3102.
Full text
2
Juariyah, Anik, Indriani, and Sulistyaningsih. "The Experience of Pregnant Women in Doing Examination to the Traditional Birth Attendants: A Systematic Literature Review." In 5th Universitas Ahmad Dahlan Public Health Conference (UPHEC 2019). Paris, France: Atlantis Press, 2020. http://dx.doi.org/10.2991/ahsr.k.200311.046.
Full text
3
Gbogbo, S., M. Ayanore, Y. Enuameh, and C. Schweppe. "P72 Lived experiences of midwives and traditional birth attendants caring for pregnant teenagers and teenage mothers: a phenomenological study." In Society for Social Medicine and Population Health Annual Scientific Meeting 2020, Hosted online by the Society for Social Medicine & Population Health and University of Cambridge Public Health, 9–11 September 2020. BMJ Publishing Group Ltd, 2020. http://dx.doi.org/10.1136/jech-2020-ssmabstracts.164.
Full textReports on the topic "Traditional birth attendants (TBAS)"
1
Gagnon, Marie-Pierre. Does training traditional birth attendants improve pregnancy outcomes? SUPPORT, 2017. http://dx.doi.org/10.30846/1702122.
Full textAbstract:
Traditional birth attendants (TBAs) who assist women are common in low-income countries. Providing formal training to untrained TBAs or additional training on specific tasks could improve care for pregnant women and pregnancy outcomes. Training programmes can differ considerably, making it difficult to make clear distinctions between initial training and additional training that are applicable across different settings.
2
Zamorano, Natalia, and Cristian Herrera. Can community-based intervention packages reduce maternal and neonatal morbidity and mortality? SUPPORT, 2017. http://dx.doi.org/10.30846/170115.
Full textAbstract:
In the last three decades, rates of neonatal mortality in low-income countries have declined much more slowly than the rates of infant and maternal mortality. A significant proportion of these deaths could potentially be addressed by community-based intervention packages, which are defined as delivering more than one intervention via different sets of strategies that include additional training of outreach workers, building community-support, community mobilization, antenatal and postnatal home visitation, training of traditional birth attendants, antenatal and delivery home visitation, and home-based neonatal care and treatment; usually supplemented by strengthening linkages with local health systems.
3
Traditional birth attendants in maternal health programmes. Population Council, 2003. http://dx.doi.org/10.31899/rh2003.1017.
Full textAbstract:
Despite the tremendous resources invested in training Traditional Birth Attendants (TBAs) over the past two decades, scientific evidence from around the world has shown that training TBAs has not reduced maternal mortality. Any improvement observed when TBA training programs have been introduced was because of the associated supervision and referral systems, and the quality of essential obstetric services available at first referral level. Conversely, evidence has shown reduced maternal and perinatal morbidity and mortality when women have a “Skilled Attendant” (a qualified health care provider who has midwifery or obstetric skills) present at every birth. Thus, national safe motherhood programs, including in Kenya, are now focusing on increasing the number of Skilled Attendants, whether a woman delivers in a facility or at home. Since TBAs are highly regarded by their communities, it is critical that they still be enabled to play a role in improving maternal health. As noted in this brief, the continued preference for TBAs in Western Province can be attributed to their proximity to the woman’s home, respectful attitude toward women, and flexible modes of payment. Problems can arise, however, when TBAs delay seeking skilled care for women in difficult labor.
4
Taking maternal services to pregnant women: The community midwifery model. Population Council, 2005. http://dx.doi.org/10.31899/rh16.1011.
Full textAbstract:
Evidence from a number of studies globally has shown a reduction in maternal and perinatal mortality when women have a skilled attendant present at birth. In Kenya, a skilled attendant assists at only 42 percent of births. In Central Province, over 70 percent deliver with a skilled attendant compared to 28 percent in Western Province. Results from one district in Western Province where midwives were given the necessary equipment and support to assist women during birth at home, showed a significant increase in home births attended by skilled health workers between 2001 and 2003 and a similar decrease in utilization of traditional birth attendants. As noted in this brief, this an indication that skilled attendance in the community is possible and a good alternative for women who are unable to reach a health facility. Building on these results, a Community Midwifery Model was developed that focuses on empowering midwives living in the community to assist women during pregnancy, childbirth, and the postpartum period in their homes, manage minor complications, and facilitate referral when necessary and transfer to the hospital.