impact of trained traditional birth attendant on health care delivery system among women of childbearing age

impact of trained traditional birth attendant on health care delivery system among women of childbearing age

CHAPTER ONE

INTRODUCTION

Abstract 

This study aimed at examining “The Impact of Trained Traditional Birth Attendants in Health Care Delivery System in Obot Akara Local Government Area, Akwa Ibom State.” To guide the study, three (3) objectives were set thus: To examine the role of TBAs on reproductive health, to find out the need of training traditional birth attendants, and to determine the impacts of training of traditional birth attendants. Three (3) research questions were also formulated and related literatures were reviewed based on the set objectives.

The study employed a descriptive survey method.  The sample size of 100 respondents was selected using stratified random sampling technique. The main instrument for data collection was questionnaire. Data collected were analysed using simple percentages and were presented in tables. Findings revealed the role of TBAs on reproductive health; it also revealed the need to train Traditional Birth Attendants, and the impacts of training traditional birth attendants. Based on these findings, conclusion was drawn and suggestions were made in the study.

1.1    Background of the Study

Child birth is an important socio-demographic and cultural event in family and community and a time of great joy and hope. In the past, child delivery was assisted by mother-in-law, mother and aunt or sister-in-law before the coming of conventional medicine (Kayombo, 2011). However, where there was complication in childbirth, traditional birth attendants (TBAs) were invited to help (Kayombo, 2011, 2012).

A traditional birth attendant is defined as a person who assists the mother during child birth and initially acquired her skills by delivering babies herself or through apprenticeship to other traditional birth attendants (WHO, 2010). Traditional birth attendants are integral members of their communities and provide an important window to local customs, traditions and members of their communities and perceptions regarding childbirth and new-born care (Kamal, 2009; Leedam, 2011).

The presence of relatives at birth was to witness child delivery and make proper decision when problem arises (Kayombo, 2011). Death of mothers or infants were translated as bad omen or God wishes or transgressing cultural norms (Kayombo, 2012).

impact of trained traditional birth attendant on health care delivery system among women of childbearing age

With the coming of conventional medicine during the colonial period, conventional health services were gradually introduced both in rural and urban and more so after independence (Kimambo and Temu, 2010). With the widespread of health facilities both in rural and urban areas, it was expected that many of the child bearing women would be using health facilities for child deliveries and other reproductive health services.

However, in sub Saharan African countries example Ghana, Nigeria, Chad etc, many child bearing women are still being attended to by TBAs and relatives at deliveries (Bergstrom and Goodburn, 2012). But studies reviewed show that births without access to life-saving drugs are the commonest practice for millions of mothers in the poorest countries where mortality rate and morbidity of the mothers are highest (Crowe, et al, 2012; WHO, 2010). Recent statistics indicate that across the world 287,000 women die in pregnancy and childbirth every year (WHO, 2010).

This is translated as one mother dying every 2 minutes, 800 a day. Not only that but also 7 – 10 million women and girls suffer severe or long term illness caused by complications in pregnancy and childbirth (WHO, 2010). The use of unskilled personnel (including TBAs) is likely to be among the reasons for the high maternal and infant mortality rate in sub Saharan Africa. Despite the expansion of more health facilities close to the community, increased use of antenatal clinic and increased coverage of immunization, the problem has persisted (MOH, 2012).

There are several factors that need to be addressed to build on effective intervention framework of reducing maternal and infant mortality rate. The questions include:

• What has been the major role of TBAs in reproductive health that attracts many women to prefer to use them for delivery and other health problems?
• Are there any efforts to train TBAs as intervention and what approaches are used in order to improve health care outcomes?
• If yes what is the impact of training TBAs on reducing maternal and infant mortality rate?

1.2    Statement of the Problem

The topic became an area of interest to study as a result of the realization that, some pregnant women encountered a lot of problem during delivery from traditional birth attendants.

Similarly, it is also assumed that a sizeable number of the pregnant women tend not to know the implication or problems that could occur from the complications of pregnancy, labour and peuperium. Furthermore, they are not familiar with the preventive measures to these complications from becoming a life-long problem or leading to their death.

The increasing report of the cases of pregnant women that died during pregnancy or encounter life-long problems makes it necessary to research on ways of solving/preventing these problems.

impact of trained traditional birth attendant on health care delivery system among women of childbearing age

1.3    Objectives of the Study

The overall objective of the this study is to determine the impact of trained traditional birth attendant on health care delivery system among women of childbearing age (mothers) in Obot Akara Local Government Area.

Specifically, the following objectives will guide the study.

1. To examine the role of TBAs on reproductive health
2. To find out the need of training traditional birth attendants.
3. To determine the impacts of training of traditional birth attendants.

1.4    Research Questions

(i)      What are the roles of traditional birth attendants on reproductive health?

(ii)     Why is it important to train traditional birth attendants?

(iii)    What are the impacts of training traditional birth attendants?

1.5    Significance of the Study

1. It will help the community to know the type of health care delivery services needed by them.
2. It will help other researchers in gathering information for their research work.
3. It will help the government in planning, implementation and evaluation of subsequent training programme for traditional birth attendants in Obot Akara Local Government Area.

1.6    Scope of the Study

This study focused on the impacts of trained traditional birth attendants. The topic will cover the role of TBAs on reproductive health, the need of training TBAs and the impact of trained TBAs. The study is delimited to men and women in Obot Akara Local Government Area, Akwa Ibom State.