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      Traditional Birth Attendants and Policy Ambivalence in Zimbabwe

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      Journal of Anthropology
      Hindawi Limited

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          Abstract

          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.

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          Most cited references15

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          Health seeking behaviour and health service utilization in Pakistan: challenging the policy makers.

          There is a growing literature on health seeking behaviours and the determinants of health services utilization especially in the context of developing countries. However, very few focused studies have been seen in Pakistan in this regard. This paper presents an extensive literature review of the situation in developing countries and relates the similar factors responsible for shaping up of a health seeking behaviour and health service utilization in Pakistan. The factors determining the health behaviours may be seen in various contexts: physical, socio-economic, cultural and political. Therefore, the utilization of a health care system, public or private, formal or non-formal, may depend on socio-demographic factors, social structures, level of education, cultural beliefs and practices, gender discrimination, status of women, economic and political systems environmental conditions, and the disease pattern and health care system itself. Policy makers need to understand the drivers of health seeking behaviour of the population in an increasingly pluralistic health care system. Also a more concerted effort is required for designing behavioural health promotion campaigns through inter-sectoral collaboration focusing more on disadvantaged segments of the population.
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            Effect of shifting policies on traditional birth attendant training.

            Traditional birth attendant (TBA) training commenced in many places in the non-Western world in the 1970s, supported by the World Health Organization and other funding bodies. By 1997, senior policy makers decided to refocus priorities on the provision of "skilled attendants" to assist birthing women. The definition of skilled attendants excluded TBAs and resulted in the subsequent withdrawal of funding for TBA training globally. A review of the health and sociological literature and international policy documents that address TBA training revealed how international policy and professional orientation are reflected in education programs designed for the TBA. Policy makers risk ignoring the important cultural and social roles TBAs fulfill in their local communities and fail to recognize the barriers to the provision of skilled care. The provision of skilled attendants for all birthing women cannot occur in isolation from TBAs who in themselves are also highly skilled. This article argues a legitimacy of alternative worldviews and acknowledges the contribution TBAs make to childbearing women across the world.
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              Assessing the role of traditional birth attendants (TBAs) in health care delivery in Edo State, Nigeria.

              This study was conducted to assess the role of traditional birth attendants (TBAs) in modern health care delivery in Edo State, Nigeria. A total of 391 respondents comprising 48 TBAs, 309 childbearing mothers and 34 medical and para-medical professionals constituted the study sample. In-depth interviews and focus group discussions as well as validated questionnaires were the tools used for data collection. The results reveal that respondents believe that TBAs can play meaningful roles in family planning, screening of high-risk pregnant mothers, fertility/infertility treatment and maternal and child care services. Rural dwellers prefer to use the services of TBAs, as compared to their urban counterparts. Reasons for the preference included TBAs, availability, accessibility, cheap services and rural dwellers' faith in the efficacy of their services. There is, therefore, the need to restructure the training of TBAs as well as to fully integrate their services into the Nigerian orthodox healthcare delivery system especially as they affect rural settings.
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                Author and article information

                Journal
                Journal of Anthropology
                Journal of Anthropology
                Hindawi Limited
                2090-4045
                2090-4053
                2014
                2014
                : 2014
                : 1-9
                Affiliations
                [1 ]Sociology Department, University of Zimbabwe, P.O. Box MP 167, Mount Pleasant, Harare, Zimbabwe
                Article
                10.1155/2014/750240
                23cfdf9a-6f4b-4444-993e-092ad469d434
                © 2014

                http://creativecommons.org/licenses/by/3.0/

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