Assessment of the role of traditional birth attendants in maternal health care in Oredo Local Government Area, Edo State, Nigeria

Abstract

Background: Since the adoption of the Primary Health Care (PHC) approach in Nigeria in 1979, government has recognized the need for integrating traditional birth attendants (TBAs) into the PHC system and had consequently initiated TBAs training programmes. In spite of the high patronage of traditional birth attendants, many of their practices during childbirth have been found to adversely affect the health of mothers. This study aimed at assessing the role of TBAs in maternal health in Oredo Local Government, Benin City, Edo-State, Nigeria.
Methodology: All the TBAs identified through snowball method within the LGA consented to providing information, through interviewer-administered questionnaires on their reproductive health practices.
Results: Of the 45 TBAs interviewed, forty-four (97.8%) were female. The majority (62.2%) acquired their skills through apprenticeship with relation, while 8.9% had no training at all. The services provided by the TBAs ranged from ante-natal care provided by 53.3%, child delivery, 97.8%, treatment of infertility, 60.0%, management of threatened abortion, 13.3% and circumcision of babies, 28.9%. Preparations used in the treatment of cord stump included methylated spirit used by 42.2% of the respondents, herbal preparations, 28.9%, dry heated sand, 11.1% and engine oil, 6.7%. Some of the medications used (animal dung, flies, scarification marks, and cow urine) to treat patients could serve as sources of infection. Methods of risk assessment during ante-natal care, management of delivery complications, record keeping among TBAs were found to be poor. Infection prevention methods used were also found to be poor, with more than half (51.1%) not using any form of preventive measures during procedures.
Conclusion: This study has revealed that the practices of these TBAs are not safe. There is need for improvement through a more holistic training programme including monitoring and supervision.