Incorporating traditional birth attendants into the mainstream maternal health system in Nigeria - An evaluation of the Ondo State Agbebiye program
), Olugbenga Osunmakinwa(2), Yetunde Olagbuji(3),
(1) Department of Obstetrics and Gynecology, University of Medical Sciences, Ondo State
(2) Department of Community Medicine, University of Medical Sciences, Ondo State
(3) Directorate of Planning, Research, and Statistics, Ondo State Primary Healthcare Development Board
Corresponding Author
Abstract
Historically, the roles of traditional birth attendants (TBAs) in maternity care have been contentious. In 2014, Ondo state in response to an 80% proportion of TBA-related maternal deaths launched the Agbebiye program to incorporate TBAs. This study which aimed to evaluate the program involved a retrospective review of maternity records between 2013 and 2016. The results showed that the seven-month pilot phase in the state capital witnessed a reduction in TBA-related deaths when compared to the previous year. Overall, 5,606 TBAs were coopted with resultant 14,124 referrals out of 142,206 facility deliveries (9.9% referral rate). Additionally, there was a 61.8% increase in facility births from 33,077 in 2013 to 53,531 in 2016. During program implementation, there were seven maternal deaths linked to Agbebiye-registered TBAs out of 260 statewide facility deaths (2.7%). Our study confirms the positive role that TBAs’ incorporation into the maternal healthcare system can play in reducing maternal deaths in low-resource countries. (Afr J Reprod Health 2021; 25[4]: 82-88).
References
WHO/UNICEF/UNFPA, World Bank Group, and the
United Nations Population, Division. Trends in maternal mortality: 1990–2015. Geneva: WHO; 2015
National Population Commission (Nigeria) and ICF
International. Nigeria Demographic and Health Survey 2013. Abuja and Rockville, USA: National Population Commission and ICF International; 2014.
National Population Commission (Nigeria) and ICF
International. Nigeria Demographic and Health Survey 2018 Key Indicators’ Report. Abuja, Nigeria and Rockville, Maryland, USA: National Population Commission and ICF International;
World Health Organization. Making pregnancy safer: the
critical role of the skilled attendant. A joint statement by WHO, ICM and FIGO. Geneva: WHO; 2004.
World Health Organization. Definition of skilled health
personnel providing care during childbirth. A joint statement by WHO, UNFPA, UNICEF, ICM, ICN, FIGO and IPA. Geneva: WHO; 2018.
World Health Organization. Reduction of maternal
mortality. A joint WHO/UNFPA/UNICEF/World Bank statement. Geneva: WHO; 1999.
Ana J and Harrison K. Are traditional birth attendants
good for improving maternal and perinatal health? BMJ 2011;342: d3310. doi:10.1136/bmj. d3310.
Doherty C, Ajayi R and Ajumobi Y. A critical assessment
on the need for integrating alternative birth attendant into prevention of mother to child transmission of HIV (PMTCT) programme in Ekiti State, Nigeria. Texila Int J Public Health 2019; 7:1-15.
Bukar M and Jauro Y. Home births and postnatal practices
in Madagali, north eastern Nigeria. Niger J Clin Pract 2013; 16:232-237.
Oshonwoh F, Nwankwo G and Ekiyor C. Traditional birth
attendants and women’s health practices: a case study of Patani in southern Nigeria. J Public Health Epidemiol. 2014; 6:252-261.
Nduka I and Nduka E. Determinants of non-institutional
deliveries in an urban community in Nigeria. J Med Invest Pract. 2014; 9:102-107.
Ebuehi O and Akintujoye I. Perception and utilization of
traditional birth attendants by pregnant women attending primary health care clinics in a rural local government area in Ogun State, Nigeria. Int J Women’s Health. 2012; 4:25-34.
Abubakar A, Sambo M and Idris S. Awareness and
utilization of antenatal care services and delivery services in a rural community, Northwestern Nigeria. KJMS. 2011; 5:43-49.
Abodunrin O, Akande T, Musa I and Aderibigbe S.
Determinants of referral practices of clients by traditional birth attendants in Ilorin, Nigeria. Afr J Reprod Health. 2010; 14:77-84.
Balogun M and Odeyemi K. Knowledge and practice of
prevention of mother-to-child transmission of HIV among traditional birth attendants in Lagos State, Nigeria. Pan Afr Med J. 2010; 5:7.
Agbo MAE. Training of traditional birth attendants: a
strategy for reduction of maternal and infant mortality. West Afr J Nurs. 2013; 24:42-52.
Sulayman H and Adaji S. Integration of traditional birth
attendants into the health sector for improving maternal health in Nigeria: a systematic review. Sub-Saharan Afr J Med. 2019; 6:55-62.
Amutah-Onukagha N, Rodriguez M, Opara I, Gardner M,
Assan MA, Hammond R, Plata J, Pierre K and Farag E. Progresses and challenges of utilizing traditional birth attendants in maternal and child health in Nigeria. Int J MCH AIDS. 2017; 6:130-138.
Byrne A and Morgan A. How the integration of traditional
birth attendants with formal health system can increase skilled birth attendance. Int J Gynecol Obstet 2011; 115:127-134.
Mimiko O. Experiences with universal health coverage of
maternal health care in Ondo State, Nigeria. Afr J Reprod
Health. 2017; 21:9-16.
Oyeneyin L, van den Akker T, Durojaiye O, Obaado O,
Akanbiemu F, Olagbuji Y, Aladeniyi I, Oyeneyin M and Aladenola O. Confidential enquiries into maternal deaths in Ondo State, Nigeria – a comparative analysis. BMC Pregnancy Childbirth. 2019; 19:514. https://doi.org/10.1186/s12884-019-2659-y
National Population Commission. The Nigeria Population
Census. 2006. http://www.population.gov.ng/index.php?option=com_content&view=article&id=89. Accessed on 10 Jul 2017.
Oyeneyin LO, Akintan AL, Aderoba AK and Owa OO.
Maternal mortality ratio in a tertiary hospital offering free maternity services in South-western Nigeria – A five-year review. Trop J Obstet Gynaecol. 2017; 34:112-5.
Umeora O, Eze J, Igberase G and Ejikeme B. An audit of
postpartum referrals by traditional birth attendants in rural southeast Nigeria. Niger J Surg Sci. 2015; 25: 4-8.
Chukwuma A, Mbachu C, McConnell M, Bossert T and
Cohen J. The impact of monetary incentives on referrals by traditional birth attendants for postnatal care in Nigeria. BMC Pregnancy Childbirth. 2019; 19:150. https://doi.org/10.1186/s12884-019-2313-8
World Health Organization. Declaration of Alma Atta:
International Conference on Primary Health Care, Alma Atta, USSR, 6-12 September 1978. Accessed from https://www.who.int on 19th March 2021.
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