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The Role of Trained Birth Attendants in Delivering PMTCT Services

Received: 5 June 2015     Accepted: 15 June 2015     Published: 2 July 2015
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Abstract

Nigeria was part of an HIV epidemic that once threatened to engulf all of West Africa. The trajectory was altered by the interventions of international donor agencies such as the US President’s Emergency Plan for AIDS Relief (PEPFAR), local organizations, and other agencies who assisted in reducing the threat. Birth Attendants provide an important resource for Prevention of Mother-to-Child Transmission of HIV (PMTCT) as they are more affordable and accessible to most women living in the rural parts of poor developing countries like Nigeria. In March 2004, Faith Alive Foundation (FAF), in collaboration with Global Strategies for HIV Prevention, organized a training workshop for Traditional (trained) Birth Attendants (TBAs) providing services in Plateau State. The workshop curriculum was developed by Global Strategies for HIV Prevention and included HIV Prevention and Care, Voluntary Counseling and Testing (VCT) or HIV Counseling and Testing (HCT), safe delivery practices, and methods for sterilizing instruments. The trained TBAs were followed up by a Faith Alive project coordinator, who was responsible for providing continued oversight, record-keeping, quality assurance, and ongoing education and training. After more than 10 years of implementation and support, a program for PMTCT utilizing TBAs proved to be an important and sustainable tool for HIV Prevention. TBAs were able to provide insight into the lives of women in the community and to use their own experience to help bridge the gap between the clinical setting and the realities of culture and economics that often face women in Africa. Additionally, offering VCT to their clients and referral of HIV-positive women to Faith Alive provided another means whereby women living in remote areas were introduced to the wider healthcare network to access HIV Care and Support as well as other diseases. The role of trained traditional birth attendants should be integrated into PMTCT services in order to ensure that couples receive HCT, women recruited into PMTCT programs receive prophylaxis at the time of delivery, and opportunities are provided to access additional broad health care benefits.

Published in American Journal of Health Research (Volume 3, Issue 4)
DOI 10.11648/j.ajhr.20150304.15
Page(s) 232-238
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2015. Published by Science Publishing Group

Keywords

TBAs, PPTCT, PMTCT, HCT, VCT, HIV Counseling, HIV Testing, Traditional Birth Attendants

References
[1] Ejele OA, Nwauche CA, Erhabor O. Seroprevalence of HIV infection among blood donors in Port Harcourt, Nigeria. Niger J Med. 2005 Jul-Sep;14(3):287-9. PubMed PMID: 16350699.
[2] Ejele OA, Nwauche CA, Erhabor O. Seroprevalence of HIV among unemployed individuals undergoing pre-employment medical examination in Port Harcourt, Nigeria. Niger J Med. 2005 Oct-Dec;14(4):419-21. PubMed PMID: 16353705.
[3] Audet CM, Hamilton E, Hughart L, Salato J. Engagement of Traditional Healers and Birth Attendants as a Controversial Proposal to Extend the HIV Health Workforce. Curr HIV/AIDS Rep. 2015 Jun;12(2):238-45. doi: 10.1007/s11904-015-0258-8. PubMed PMID: 25855337; PubMed Central PMCID: PMC4430841.
[4] Rudrum S. Traditional Birth Attendants in Rural Northern Uganda: Policy, Practice, and Ethics. Health Care Women Int. 2015 Feb 26:1-20. [Epub ahead of print] PubMed PMID: 25719535.
[5] Akalin MZ, Maine D, de Francisco A, Vaughan R. Why perinatal mortality cannot be a proxy for maternal mortality. Stud Fam Plann. 1997 Dec;28(4):330-5. PubMed PMID: 9431653.
[6] Akpala CO. An evaluation of the knowledge and practices of trained traditional birth attendants in Bodinga, Sokoto State, Nigeria. J Trop Med Hyg. 1994 Feb;97(1):46-50. PubMed PMID: 8107173.
[7] Alisjahbana A, Williams C, Dharmayanti R, Hermawan D, Kwast BE, Koblinsky M. An integrated village maternity service to improve referral patterns in a rural area in West-Java. Int J Gynaecol Obstet. 1995 Jun;48 Suppl:S83-94. PubMed PMID: 7672178.
[8] Alto WA, Albu RE, Irabo G. An alternative to unattended delivery--a training programme for village midwives in Papua New Guinea. Soc Sci Med. 1991;32(5):613-8. PubMed PMID: 2017729.
[9] Amin R, Khan AH. Characteristics of traditional midwives and their beliefs and practices in rural Bangladesh. Int J Gynaecol Obstet. 1989 Feb;28(2):119-25. PubMed PMID: 2563697.
[10] Bang AT, Bang RA, Sontakke PG. Management of childhood pneumonia by traditional birth attendants. The SEARCH Team. Bull World Health Organ. 1994;72(6):897-905. PubMed PMID: 7867135; PubMed Central PMCID: PMC2486734.
[11] Bang AT, Reddy HM, Bang RA, Deshmukh MD. Why do neonates die in rural Gadchiroli, India? (Part II): estimating population attributable risks and contribution of multiple morbidities for identifying a strategy to prevent deaths. J Perinatol. 2005 Mar;25 Suppl 1:S35-43. PubMed PMID: 15791277.
[12] Bayoumi A. The training and activity of village midwives in the Sudan. Trop Doct. 1976 Jul;6(3):118-25. PubMed PMID: 785734.
[13] De Bernis L, Dumont A, Bouillin D, Gueye A, Dompnier JP, Bouvier-Colle MH. Maternal morbidity and mortality in two different populations of Senegal: a prospective study (MOMA survey). BJOG. 2000 Jan;107(1):68-74. PubMed PMID: 10645864.
[14] De Brouwere V, Tonglet R, Van Lerberghe W. Strategies for reducing maternal mortality in developing countries: what can we learn from the history of the industrialized West? Trop Med Int Health. 1998 Oct;3(10):771-82. PubMed PMID: 9809910.
[15] Campero L, García C, Díaz C, Ortiz O, Reynoso S, Langer A. "Alone, I wouldn't have known what to do": a qualitative study on social support during labor and delivery in Mexico. Soc Sci Med. 1998 Aug;47(3):395-403. PubMed PMID: 9681909.
[16] Castañeda Camey X, García Barrios C, Romero Guerrero X, Nuñez-Urquiza RM, Gonzalez Hernández D, Langer Glass A. Traditional birth attendants in Mexico: advantages and inadequacies of care for normal deliveries. Soc Sci Med. 1996 Jul;43(2):199-207. PubMed PMID: 8844924.
[17] Chalmers B. Traditional Indian customs surrounding birth. A review. S Afr Med J. 1993 Mar;83(3):200-3. Review. PubMed PMID: 8511689.
[18] Chowdhury M. The role of traditional birth attendants in a safe delivery programme in Bangladesh. Trop Doct. 1998 Apr;28(2):104-6. PubMed PMID: 9594684.
[19] Eades CA, Brace C, Osei L, LaGuardia KD. Traditional birth attendants and maternal mortality in Ghana. Soc Sci Med. 1993 Jun;36(11):1503-7. PubMed PMID: 8511638.
[20] Fleming JR. What in the world is being done about TBAs? An overview of international and national attitudes to traditional birth attendants. Midwifery. 1994 Sep;10(3):142-7. PubMed PMID: 7815953.
[21] Goodburn EA, Gazi R, Chowdhury M. Beliefs and practices regarding delivery and postpartum maternal morbidity in rural Bangladesh. Stud Fam Plann. 1995 Jan-Feb;26(1):22-32. PubMed PMID: 7785065.
[22] Greenwood AM, Bradley AK, Byass P, Greenwood BM, Snow RW, Bennett S, Hatib-N'Jie AB. Evaluation of a primary health care programme in The Gambia. I. The impact of trained traditional birth attendants on the outcome of pregnancy. J Trop Med Hyg. 1990 Feb;93(1):58-66. PubMed PMID: 2304134.
[23] Jordan B. Cosmopolitical obstetrics: some insights from the training of traditional midwives. Soc Sci Med. 1989;28(9):925-37; discussion 937-44. PubMed PMID: 2711228.
[24] Kamal IT. The traditional birth attendant: a reality and a challenge. Int J Gynaecol Obstet. 1998 Dec;63 Suppl 1:S43-52. Review. PubMed PMID: 10075211.
[25] Koblinsky MA, Tinker A, Daly P. Programming for safe motherhood: a guide to action. Health Policy Plan. 1994 Sep;9(3):252-66. Review. PubMed PMID: 10137741.
[26] Maternal anthropometry for prediction of pregnancy outcomes: memorandum from a USAID/WHO/PAHO/MotherCare meeting. Bull World Health Organ. 1991;69(5):523-32. PubMed PMID: 1959155; PubMed Central PMCID: PMC2393257.
[27] Kwast BE. Midwives: key rural health workers in maternity care. Int J Gynaecol Obstet. 1992 Jun;38 Suppl:S9-15. PubMed PMID: 1354189.
[28] Kwast BE. Building a community-based maternity program. Int J Gynaecol Obstet. 1995 Jun;48 Suppl:S67-82. PubMed PMID: 7672176.
[29] Kwast BE. Reduction of maternal and perinatal mortality in rural and peri-urban settings: what works? Eur J Obstet Gynecol Reprod Biol. 1996 Oct;69(1):47-53. Review. PubMed PMID: 8909956.
[30] Kwast BE, Rochat RW, Kidane-Mariam W. Maternal mortality in Addis Ababa, Ethiopia. Stud Fam Plann. 1986 Nov-Dec;17(6 Pt 1):288-301. PubMed PMID: 3798492.
[31] Lartson LI, Sodipe OA, Ebrahim GJ, Abel R. The trained traditional birth attendant: a study of her role in two cultures. J Trop Pediatr. 1987 Feb;33(1):29-34. PubMed PMID: 3573132.
[32] Leedam E. Traditional birth attendants. Int J Gynaecol Obstet. 1985 Sep;23(4):249-74. PubMed PMID: 2866113.
[33] Lefèber Y, Voorhoever H. Practices and beliefs of traditional birth attendants: lessons for obstetrics in the north? Trop Med Int Health. 1997 Dec;2(12):1175-9. Review. PubMed PMID: 9438474.
[34] Mathur HN, Damodar, Sharma PN, Jain TP. The impact of training traditional birth attendants on the utilisation of maternal health services. J Epidemiol Community Health. 1979 Jun;33(2):142-4. PubMed PMID: 490094; PubMed Central PMCID: PMC1051939.
[35] O'Rourke K. The effect of hospital staff training on management of obstetrical patients referred by traditional birth attendants. Int J Gynaecol Obstet. 1995 Jun;48 Suppl:S95-102. PubMed PMID: 7672179.
[36] Ronsmans C, Vanneste AM, Chakraborty J, van Ginneken J. Decline in maternal mortality in Matlab, Bangladesh: a cautionary tale. Lancet. 1997 Dec 20-27;350(9094):1810-4. PubMed PMID: 9428252.
[37] Ross DA. The trained traditional birth attendant and neonatal tetanus. WHO Offset Publ. 1986;(95):8-21. Review. PubMed PMID: 3529701.
[38] Sai FT, Measham DM. Safe Motherhood Initiative: getting our priorities straight. Lancet. 1992 Feb 22;339(8791):478-80. PubMed PMID: 1346829.
[39] Semali IA. Some aspects of traditional birth attendants' practice in a rural area in Tanzania. Trans R Soc Trop Med Hyg. 1992 May-Jun;86(3):330-1. PubMed PMID: 1412669.
[40] Sibley L, Armbruster D. Obstetric first aid in the community--partners in safe motherhood. A strategy for reducing maternal mortality. J Nurse Midwifery. 1997 Mar-Apr;42(2):117-21. PubMed PMID: 9107120.
[41] Singh A. Profile of traditional birth attendants in a rural area of north India. J Nurse Midwifery. 1994 Mar-Apr;39(2):119-23. PubMed PMID: 8027848.
[42] Smith JB, Coleman NA, Fortney JA, Johnson JD, Blumhagen DW, Grey TW. The impact of traditional birth attendant training on delivery complications in Ghana. Health Policy Plan. 2000 Sep;15(3):326-31. PubMed PMID: 11012408.
[43] Walraven G, Weeks A. The role of (traditional) birth attendants with midwifery skills in the reduction of maternal mortality. Trop Med Int Health. 1999 Aug;4(8):527-9. PubMed PMID: 10499075.
[44] Shabbal DM, Jamda MA, Dalhatu IT, Abdulrahman MB, Isichei C. Comparison of microalbuminuria among treatment naïve HIV sero-positive and negative adult clients in Faith Alive Foundation Hospital, Jos. Niger Med J. 2014 Nov;55(6):508-11. doi: 10.4103/0300-1652.144711. PubMed PMID: 25538372; PubMed Central PMCID: PMC4262850.
[45] Ogoina D, Pondei K, Adetunji B, Chima G, Isichei C, Gidado S. Prevalence of hepatitis B vaccination among health care workers in Nigeria in 2011-12. Int J Occup Environ Med. 2014 Jan;5(1):51-6. PubMed PMID: 24463801.
[46] Ogoina D, Pondei K, Adetunji B, Chima G, Isichei C, Gidado S. Prevalence and determinants of occupational exposures to blood and body fluids among health workers in two tertiary hospitals in Nigeria. Afr J Infect Dis. 2014;8(2):50-4. PubMed PMID: 25729538; PubMed Central PMCID: PMC4325361.
[47] Anigbogu CN, Isichei CV, Ajuluchukwu JN. Blood pressure, heart rate, cardiovascular reflexes and electrocardiographic changes in some hypertensive Nigerians. Niger J Physiol Sci. 2012 Jun 7;27(1):23-7. PubMed PMID: 23235304.
[48] John C, Okolo SN, Isichei C. Nonconsensual sexual relationship and prevalence of HIV infection in adolescent in Jos, Nigeria. Niger Med J. 2012 Oct;53(4):210-2. doi: 10.4103/0300-1652.107555. PubMed PMID: 23661880; PubMed Central PMCID: PMC3640241.
[49] Iroezindu MO, Agbaji OO, Daniyam CA, Isiguzo GC, Isichei C, Akanbi MO. Liver function test abnormalities in Nigerian patients with human immunodeficiency virus and hepatitis B virus co-infection. Int J STD AIDS. 2013 Jun;24(6):461-7. doi: 10.1177/0956462412473889. Epub 2013 Jun 24. PubMed PMID: 23970749.
[50] Durosaro O, Comfere N, Silas G, Isichei C, El-Azhary R. Dermatology and early Human Immunodeficiency Virus (HIV)/Acquired Immune Deficiency Syndrome (AIDS) recognition in Faith Alive Clinic Jos, Nigeria: a third year medical student experience. Int J Dermatol. 2009 Dec;48(12):1334-7. doi: 10.1111/j.1365-4632.2009.04196.x. PubMed PMID: 19930491.
[51] DeSilva MB, Merry SP, Fischer PR, Rohrer JE, Isichei CO, Cha SS. Youth, unemployment, and male gender predict mortality in AIDS patients started on HAARTin Nigeria. AIDS Care. 2009 Jan;21(1):70-7. doi: 10.1080/09540120802017636. PubMed PMID: 19085222; PubMed Central PMCID: PMC2849645.
[52] Lum H, Isichei C, Isichei-Wakili M, Redfield R. Expansion of HIV-1 screening and anti-retroviral treatment programs in a resource-poor setting: results from a faith-based organization in Jos, Plateau State, Nigeria. Afr Health Sci. 2007 Jun;7(2):93-100. PubMed PMID: 17594286; PubMed Central PMCID: PMC1925274.
[53] Odugbemi T, Oyewole F, Isichei CS, Onwukeme KE, Adeyemi-Doro FA. Single oral dose of azithromycin for therapy of susceptible sexually transmitted diseases: a multicenter open evaluation. West Afr J Med. 1993 Jul-Sep;12(3):136-40. PubMed PMID: 8312208.
Cite This Article
  • APA Style

    Christian O. Isichei, Arthur J. Ammann. (2015). The Role of Trained Birth Attendants in Delivering PMTCT Services. American Journal of Health Research, 3(4), 232-238. https://doi.org/10.11648/j.ajhr.20150304.15

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    ACS Style

    Christian O. Isichei; Arthur J. Ammann. The Role of Trained Birth Attendants in Delivering PMTCT Services. Am. J. Health Res. 2015, 3(4), 232-238. doi: 10.11648/j.ajhr.20150304.15

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    AMA Style

    Christian O. Isichei, Arthur J. Ammann. The Role of Trained Birth Attendants in Delivering PMTCT Services. Am J Health Res. 2015;3(4):232-238. doi: 10.11648/j.ajhr.20150304.15

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  • @article{10.11648/j.ajhr.20150304.15,
      author = {Christian O. Isichei and Arthur J. Ammann},
      title = {The Role of Trained Birth Attendants in Delivering PMTCT Services},
      journal = {American Journal of Health Research},
      volume = {3},
      number = {4},
      pages = {232-238},
      doi = {10.11648/j.ajhr.20150304.15},
      url = {https://doi.org/10.11648/j.ajhr.20150304.15},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajhr.20150304.15},
      abstract = {Nigeria was part of an HIV epidemic that once threatened to engulf all of West Africa. The trajectory was altered by the interventions of international donor agencies such as the US President’s Emergency Plan for AIDS Relief (PEPFAR), local organizations, and other agencies who assisted in reducing the threat. Birth Attendants provide an important resource for Prevention of Mother-to-Child Transmission of HIV (PMTCT) as they are more affordable and accessible to most women living in the rural parts of poor developing countries like Nigeria. In March 2004, Faith Alive Foundation (FAF), in collaboration with Global Strategies for HIV Prevention, organized a training workshop for Traditional (trained) Birth Attendants (TBAs) providing services in Plateau State. The workshop curriculum was developed by Global Strategies for HIV Prevention and included HIV Prevention and Care, Voluntary Counseling and Testing (VCT) or HIV Counseling and Testing (HCT), safe delivery practices, and methods for sterilizing instruments. The trained TBAs were followed up by a Faith Alive project coordinator, who was responsible for providing continued oversight, record-keeping, quality assurance, and ongoing education and training. After more than 10 years of implementation and support, a program for PMTCT utilizing TBAs proved to be an important and sustainable tool for HIV Prevention. TBAs were able to provide insight into the lives of women in the community and to use their own experience to help bridge the gap between the clinical setting and the realities of culture and economics that often face women in Africa. Additionally, offering VCT to their clients and referral of HIV-positive women to Faith Alive provided another means whereby women living in remote areas were introduced to the wider healthcare network to access HIV Care and Support as well as other diseases. The role of trained traditional birth attendants should be integrated into PMTCT services in order to ensure that couples receive HCT, women recruited into PMTCT programs receive prophylaxis at the time of delivery, and opportunities are provided to access additional broad health care benefits.},
     year = {2015}
    }
    

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    T1  - The Role of Trained Birth Attendants in Delivering PMTCT Services
    AU  - Christian O. Isichei
    AU  - Arthur J. Ammann
    Y1  - 2015/07/02
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    JF  - American Journal of Health Research
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    AB  - Nigeria was part of an HIV epidemic that once threatened to engulf all of West Africa. The trajectory was altered by the interventions of international donor agencies such as the US President’s Emergency Plan for AIDS Relief (PEPFAR), local organizations, and other agencies who assisted in reducing the threat. Birth Attendants provide an important resource for Prevention of Mother-to-Child Transmission of HIV (PMTCT) as they are more affordable and accessible to most women living in the rural parts of poor developing countries like Nigeria. In March 2004, Faith Alive Foundation (FAF), in collaboration with Global Strategies for HIV Prevention, organized a training workshop for Traditional (trained) Birth Attendants (TBAs) providing services in Plateau State. The workshop curriculum was developed by Global Strategies for HIV Prevention and included HIV Prevention and Care, Voluntary Counseling and Testing (VCT) or HIV Counseling and Testing (HCT), safe delivery practices, and methods for sterilizing instruments. The trained TBAs were followed up by a Faith Alive project coordinator, who was responsible for providing continued oversight, record-keeping, quality assurance, and ongoing education and training. After more than 10 years of implementation and support, a program for PMTCT utilizing TBAs proved to be an important and sustainable tool for HIV Prevention. TBAs were able to provide insight into the lives of women in the community and to use their own experience to help bridge the gap between the clinical setting and the realities of culture and economics that often face women in Africa. Additionally, offering VCT to their clients and referral of HIV-positive women to Faith Alive provided another means whereby women living in remote areas were introduced to the wider healthcare network to access HIV Care and Support as well as other diseases. The role of trained traditional birth attendants should be integrated into PMTCT services in order to ensure that couples receive HCT, women recruited into PMTCT programs receive prophylaxis at the time of delivery, and opportunities are provided to access additional broad health care benefits.
    VL  - 3
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Author Information
  • Department of Chemical Pathology, Faculty of Medical Sciences, University of Jos, Jos, Nigeria

  • Global Strategies for HIV Prevention, California, USA

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