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      PERSISTENT MISSION HOME DELIVERY IN IBADAN: ATTRACTIVE ROLE OF TRADITIONAL BIRTH ATTENDANTS

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          Abstract

          Background and objective:

          One of the major factors responsible for high maternal and neonatal deaths in Nigeria and other developing countries is the use of Traditional Birth Attendants (TBAs). The current study was carried out to evaluate the attractive roles of the TBAs that make pregnant mothers persistently use them.

          Methodology:

          The study was conducted in Ido and Lagelu local government areas of Oyo State in Nigeria. TBA basic demographic data were collected and were then followed up for a period of six months by trained Nurses and Doctors targeting a total of ten direct observations made per TBA per ANC/delivery.

          Results:

          There were a total of 146 TBAs out of which 134 fulfilled the inclusion criteria and were recruited into the study. The Male to female ratio was 1/133 and age range was 22–68 years with 70.1 % above 40 years. Seventy two per cent of them had only elementary school and 72%, 30% and 38% had been re-trained by LGA, SMOH and National TBA associations respectively. Post- partum care, counseling services, tender care in labour, easy accessibility, accommodating other relations, installmental payment were observed in all TBAs while 60–98% of them did home visit, assisted in referral and arranged for USS and laboratory services.

          Conclusions and Recommendations:

          These good practices should be incorporated into formal health sector and attitudinal change in the current health workers across all health care levels should be encouraged. CHEWs should also be primarily involved in home visit in pregnancy and post-natal care services.

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          Most cited references10

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          Evidence-based, cost-effective interventions: how many newborn babies can we save?

          Gary Darmstadt, Zulfiqar Bhutta, Simon Cousens … (2005)
          In this second article of the neonatal survival series, we identify 16 interventions with proven efficacy (implementation under ideal conditions) for neonatal survival and combine them into packages for scaling up in health systems, according to three service delivery modes (outreach, family-community, and facility-based clinical care). All the packages of care are cost effective compared with single interventions. Universal (99%) coverage of these interventions could avert an estimated 41-72% of neonatal deaths worldwide. At 90% coverage, intrapartum and postnatal packages have similar effects on neonatal mortality--two-fold to three-fold greater than that of antenatal care. However, running costs are two-fold higher for intrapartum than for postnatal care. A combination of universal--ie, for all settings--outreach and family-community care at 90% coverage averts 18-37% of neonatal deaths. Most of this benefit is derived from family-community care, and greater effect is seen in settings with very high neonatal mortality. Reductions in neonatal mortality that exceed 50% can be achieved with an integrated, high-coverage programme of universal outreach and family-community care, consisting of 12% and 26%, respectively, of total running costs, plus universal facility-based clinical services, which make up 62% of the total cost. Early success in averting neonatal deaths is possible in settings with high mortality and weak health systems through outreach and family-community care, including health education to improve home-care practices, to create demand for skilled care, and to improve care seeking. Simultaneous expansion of clinical care for babies and mothers is essential to achieve the reduction in neonatal deaths needed to meet the Millennium Development Goal for child survival.
          Article 0 comments Cited 550 times – based on 0 reviews     Review now
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            Factors affecting home delivery in rural Tanzania.

            Mwifadhi Mrisho, Joanna A Schellenberg, Adiel K Mushi … (2007)
            Studies of factors affecting place of delivery have rarely considered the influence of gender roles and relations within the household. This study combines an understanding of gender issues relating to health and help-seeking behaviour with epidemiological knowledge concerning place of delivery. In-depth interviews, focus group discussions and participant observation were used to explore determinants of home delivery in southern Tanzania. Quantitative data were collected in a cross-sectional survey of 21,600 randomly chosen households. Issues of risk and vulnerability, such as lack of money, lack of transport, sudden onset of labour, short labour, staff attitudes, lack of privacy, tradition and cultures and the pattern of decision-making power within the household were perceived as key determinants of the place of delivery. More than 9000 women were interviewed about their most recent delivery in the quantitative survey. There were substantial variations between ethnic groups with respect to place of delivery (P<0.0001). Women who lived in male-headed households were less likely to deliver in a health facility than women in female-headed households (RR 0.86, 95% CI 0.80-0.91). Mothers with primary and higher education were more likely to deliver at a health facility (RR 1.30, 95% CI 1.23-1.38). Younger mothers and the least poor women were also more likely to deliver in a health facility compared with the older and the poorest women, respectively. To address neonatal mortality, special attention should be paid to neonatal health in both maternal and child health programmes. The findings emphasize the need for a systematic approach to overcome health-system constraints, community based programmes and scale-up effective low-cost interventions which are already available.
            Article 0 comments Cited 137 times – based on 0 reviews     Review now
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              Low use of rural maternity services in Uganda: impact of women's status, traditional beliefs and limited resources.

              Grace Kyomuhendo (2003)
              In Uganda, lack of resources and skilled staff to improve quality and delivery of maternity services, despite good policies and concerted efforts, have not yielded an increase in utilisation of these services by women or a reduction in the high ratio of maternal deaths. This paper reports a study conducted from November 2000 to October 2001 in Hoima, a rural district in western Uganda, whose aim was to enhance understanding of why, when faced with complications of pregnancy or delivery, women continue to choose high risk options leading to severe morbidity and even their own deaths. The findings demonstrate that adherence to traditional birthing practices and beliefs that pregnancy is a test of endurance and maternal death a sad but normal event, are important factors. The use of primary health units and the referral hospital, including when complications occur, was considered only as a last resort. Lack of skilled staff at primary health care level, complaints of abuse, neglect and poor treatment in hospital and poorly understood reasons for procedures, plus health workers' views that women were ignorant, also explain the unwillingness of women to deliver in health facilities and seek care for complications. Appropriate interventions are needed to address the barriers between rural mothers and the formal health care system, including community education on all aspects of essential obstetric care and sensitisation of service providers to the situation of rural mothers.
              Article 0 comments Cited 114 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (nlm-ta): Ann Ib Postgrad Med
                Journal ID (iso-abbrev): Ann Ib Postgrad Med
                Journal ID (publisher-id): AIPM
                Title: Annals of Ibadan Postgraduate Medicine
                Publisher: Association of Resident Doctors (ARD), University College Hospital, Ibadan
                ISSN (Print): 1597-1627
                Publication date (Print): December 2012
                Volume: 10
                Issue: 2
                Pages: 22-27
                Affiliations
                Department of Paediatrics, University College Hospital, Ibadan
                Author notes
                Correspondence: Dr. A.I. Ayede Department of Paediatrics, University College Hospital, Ibadan.
                Article
                Publisher ID: AIPM-10-22
                PMC ID: 4111052
                SO-VID: 736fe75f-1000-4ff0-999e-34687a507a72
                Copyright © © Association of Resident Doctors, UCH, Ibadan
                License:

                This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

                History
                Categories
                Subject: Original Article

                Keywords: mission home,delivery,traditional birth attendants,attractive role.
                Data availability:
                Keywords: mission home, delivery, traditional birth attendants, attractive role.

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