99% of all maternal deaths occur in developing countries. Traditional birth attendants (TBAs) are in some regions of these countries the only form of maternal health service and are widely utilised in these developing countries. Within Nigeria alone 560 maternal deaths occur per 100,000 live births, and the nation contributes 14% of the global burden of maternal deaths. Despite this TBAs are highly trusted in local communities and extensively culturally engrained.
The spiritual incline and caring nature that many TBAs possess makes their services more attractive to those within the local community, this alongside a plethora of other reason constitute why the services provided by TBAs will continued to be patronised. These reasons include, financial constraints, a lack of skilled human resource, poor patient relation within formal institutions and many others. TBAs therefore present themselves as a more appealing option for childbearing in local communities in more rural regions, however this often comes at a cost. Many birth attendants lack the basic skills required for safe delivery and the prevention of post-partum complications or fatality.
TBA training programmes and initiatives directly addresses this issue, by providing safer birthing training and development to TBAs. TBAs can therefore be used as a tool to improve the positionality of maternal mortality rates in many developing countries. Hacey Health Initiative’s Project Agbebi is an effective example of such, providing training sessions and safe birthing kits to traditional birth attendants within the Ibafo region of Ogun state. The organisation places itself at the forefront of attempts to tackle maternal mortality within the region and the efforts of the organisation as a whole are extensively evident within the community.
The impact of Project Agbebi within the community were evident when visiting the head TBA in Ibafo – Mummy Israel – and her facilities. The configuration of her practice was immediately evident. Her training materials and strong desire to further cultivate the skills which she had acquired did not go unrecognised. In addition, her emphasis on sanitation in order to prevent infection or other post-partum complication were also clear. This alongside her extensive knowledge of the subject area, broad previous experience and strong links with the formal health care system makes her practice extremely safe.
Project Agbebi addresses a fundamental issue within the maternal health topic. Until sustainable generations of skilled birth attendants are achieved the services rendered by TBAs will continue to be utilised and therefore they should not be neglected, but empowered. Mummy Israel is an example of how Hacey Health Initiative has made a poistive impact in this health region and will continue to do so.
Written by Emi Michael.