scholarly journals HEALTH CARE PROVIDERS’ VIEWS CONCERNING KNOWLEDGE AND PRACTICES OF TRADITIONAL BIRTH ATTENDANTS IN TAJIKISTAN: A QUALITATIVE STUDY

2021 ◽  
Vol 3 (2) ◽  
pp. 479-495

Introduction: This study seeks to explore health care providers’ perspectives of the traditional birth attendants’ knowledge and practices. Methods: This qualitative study was conducted in 2018 with 16 health care professionals working at various levels of maternal health care system in two purposefully selected research settings, Khorog town and Dushanbe, which have different social, economic and ethnic backgrounds. Semi-structured face-to-face interviews were conducted to gather the data. Duration of interviews ranged from 30-60 min. NVivo software for qualitative research was used to analyse the results. Results: This study has shown that health care workers have extremely negative views of the knowledge and practices of traditional birth attendants. They highlight the lack of adequate knowledge of traditional birth attendants on biomedical aspects of birth, poor skills in infections control and lack of use of clean delivery practices. They also claim that the traditional birth attendants’ practices also lead to different complications while they are woefully unprepared to recognize obstetric complications during birth. Conclusion: The study recommends providing a skilled birth attendant in every area. It also recommends avoiding a homogeneous approach to address maternal health issues in diverse countries of the Global South and reviewing maternal health care policies and programs to provide the most marginalized groups of women with skilled birth services to improve their maternal health and further decrease maternal mortality in Tajikistan.

2018 ◽  
Vol 6 ◽  
pp. 205031211775363 ◽  
Author(s):  
Primus Che Chi ◽  
Henrik Urdal

Objectives: Many conflict-affected countries are faced with an acute shortage of health care providers, including skilled birth attendants. As such, during conflicts traditional birth attendants have become the first point of call for many pregnant women, assisting them during pregnancy, labour and birth, and in the postpartum period. This study seeks to explore how the role of traditional birth attendants in maternal health, especially childbirth, has evolved in two post-conflict settings in sub-Saharan Africa (Burundi and northern Uganda) spanning the period of active warfare to the post-conflict era. Methods: A total of 63 individual semi-structured in-depth interviews and 8 focus group discussions were held with women of reproductive age, local health care providers and staff of non-governmental organisations working in the domain of maternal health who experienced the conflict, across urban, semi-urban and rural settings in Burundi and northern Uganda. Discussions focused on the role played by traditional birth attendants in maternal health, especially childbirth during the conflict and how the role has evolved in the post-conflict era. Transcripts from the interviews and focus group discussions were analysed by thematic analysis (framework approach). Results: Traditional birth attendants played a major role in childbirth-related activities in both Burundi and northern Uganda during the conflict, with some receiving training and delivery kits from the local health systems and non-governmental organisations to undertake deliveries. Following the end of the conflict, traditional birth attendants have been prohibited by the government from undertaking deliveries in both Burundi and northern Uganda. In Burundi, the traditional birth attendants have been integrated within the primary health care system, especially in rural areas, and re-assigned the role of ‘birth companions’. In this capacity they undertake maternal health promotion activities within their communities. In northern Uganda, on the other hand, traditional birth attendants have not been integrated within the local health system and still appear to undertake clandestine deliveries in some rural areas. Conclusion: The prominent role of traditional birth attendants in childbirth during the conflicts in Burundi and northern Uganda has been dwindling in the post-conflict era. Traditional birth attendants can still play an important role in facilitating facility and skilled attended births if appropriately integrated with the local health system.


Author(s):  
Maja Aleksandra Milkowska-Shibata ◽  
Thin Thin Aye ◽  
San Myint Yi ◽  
Khin Thein Oo ◽  
Kyi Khaing ◽  
...  

The study objective was to examine barriers and facilitators of maternal health services utilization in Myanmar with the highest maternal mortality ratio in Southeast Asia. Data for 258 mothers with children under five were extracted from a community health survey administered between 2016 and 2017 in Mandalay, the largest city in central Myanmar, and analyzed for associations between determinants of maternal health care choices and related outcomes. The study showed that late antenatal care was underutilized (41.7%), and antenatal care attendance was significantly associated with geographical setting, household income, education, and access to transportation (p ≤ 0.05). Less than one-third of women gave birth at home and 18.5% of them did so without the assistance of traditional birth attendants. Household education level was a significant predictor for home delivery (p < 0.01). Utilization of postnatal care services was irregular (47.9%–70.9%) and strongly associated with women’s places of delivery (p < 0.01). Efforts geared towards improving maternal health outcomes should focus on supporting traditional birth attendants in their role of facilitating high-quality care and helping women reach traditional health facilities, as well as on maternal health literacy based on culturally appropriate communication.


2021 ◽  
Vol 17 ◽  
pp. 174550652110461
Author(s):  
Seboka Abebe Sori ◽  
Kedir Teji Roba ◽  
Tesfaye Assebe Yadeta ◽  
Hirut Dinku Jiru ◽  
Keyredin Nuriye Metebo ◽  
...  

Background: Provision of preconception care is significantly affected by the health care provider’s knowledge of preconception care. In Ethiopia, preconception care is rare, if even available, as part of maternal health care services. Thus, this study aimed to determine the level of knowledge of preconception care and associated factors among health care providers working in public health facilities in Eastern Ethiopia. Methods: A multicenter cross-sectional study was conducted from 1 March to 1 April 2020. A simple random sampling technique was used to select a total of 415 maternal health care providers. We utilized a structured, pretested, and self-administered questionnaire to collect data. Data were entered into EpiData (version 3.1) and exported to STATA (version 16) for analysis. Descriptive statistics and bivariate and multivariate logistic regression analyses were performed. All covariates with a p value ⩽0.20 in bivariate logistic regression were entered into a multivariate logistic regression analysis to control the confounding variables; variables with a p value <0.05 were considered statistically significant. Results: Out of 410 respondents, 247 (60.2%; 95% confidence interval: 55.4–65.1) had good knowledge of preconception care. Having an educational level of Bachelor of Science degree and above (adjusted odds ratio: 6.97, 95% confidence interval: 3.85–12.60), 5 or more years work experience (adjusted odds ratio: 2.60, 95% confidence interval: 1.52–4.49), working in a hospital (adjusted odds ratio: 2.50, 95% confidence interval: 1.25–4.99), reading preconception care guidelines (adjusted odds ratio: 3.06, 95% confidence interval: 1.40–6.68), and training on preconception (adjusted odds ratio: 2.90, 95% confidence interval: 1.37–6.15) were significantly associated with good knowledge of preconception care. Conclusions and Recommendations: Three out of five maternal health care providers in this study had good knowledge of preconception care. Facilitating continuous refreshment training and continuous professional development for health workers, preparing comprehensive preconception care guidelines for health institutions, and reading preconception care guidelines were highly recommended.


2019 ◽  
Vol 52 (3) ◽  
pp. 452-471 ◽  
Author(s):  
Suresh Jungari ◽  
Balram Paswan

AbstractIn many cultural settings worldwide, within families, men tend to be responsible for important choices relating to the allocation of household resources and care-seeking behaviour that directly impact on the health of women and newborns. This study examines the extent of male participation in antenatal care (ANC), delivery, postnatal care (PNC), household chores and providing food to wives among tribal communities in India. In addition, health care providers’ views on male participation in maternal health were examined. Primary data were collected from 385 men aged 15–49 from rural Gadchiroli District in Maharashtra, India. Interviews of 385 men whose wives had delivered a child within the previous 2 years were conducted between November 2014 and March 2015. Bivariate and multivariate analyses were done. The results showed that the tribal men’s participation in maternal health care was minimal. Around 22% of the men reported accompanying their wives to ANC, 25% were present at the time of delivery of their children and 25% accompanied their wives to PNC. Participation in household work, and support for wives in other ways, were slightly better. The main reason given by men for not participating in maternal health care was that they didn’t think it was necessary, believing that all maternal health issues were women’s concern. Health care providers among these tribal communities in India should encourage men to participate in issues related to maternal health care.


Author(s):  
Samita Bhardwaj ◽  
Sonal Raut ◽  
Vidyadhar B. Bangal

Background: Postpartum haemorrhage (PPH) is a life-threatening complication, that occurs suddenly and unexpectedly. Institutional delivery by skilled birth attendant who are trained in active management of third stage of labour and those who can use of Uterine Balloon Tamponade and Non-pneumatic anti shock garment can reduce incidence and morbidity related to PPH. The objective of the paper was to share the experiences of the training programmes held for maternal health care workers in the newer modalities of PPH management.Methods: During one and a half year period, 32 Continuation of Medical Education (CME) programmes, with the theme of “Managing Obstetric Emergencies and Obstetric Trauma”, covering important topics related to high risk pregnancies like Hypertension, Eclampsia ,Anaemia and Haemorrhage at 32 health institutions, spread over 11 states and 2 union territories in India, were conducted .In addition,42 hands on workshops  at various health facilities were conducted with training of more than 2575 maternal health care providers.Results: The pre and post test scores revealed that 95 percent of the maternal health care providers were unaware about the use of Uterine Balloon Tamponade (Bakri balloon) in PPH and Non-pneumatic anti shock garment (NASG). Seventy percent were unaware about the proper sequence of steps of active management of third stage of labour. Training programmes helped to improve the knowledge, whereas hands on workshop, helped in skill development of the health care providers. The participants expressed great satisfaction regarding the knowledge and skills they acquired through training programme on management of post-partum haemorrhage. They gave positive feedback about the quality, contents and conduct of training programme.Conclusions: There is need for refresher training of maternal health care providers in newer modalities like AMTSL, NASG and Bakri balloon, which have potential to save lives.


2017 ◽  
Vol 2 ◽  
pp. 93
Author(s):  
Alicia Giralt

Las tasas de mortalidad materna guatemalteca son las más altas de Centroamérica. Dichas tasas varían drásticamente entre grupos étnicos, con las más altas presentes entre mujeres rurales mayas. Mientras Guatemala se esfuerza para reducir estas cifras, la controversia se centra en comadronas tradicionales. Esta investigación estudia el papel de dichas comadronas dentro de un marco postcolonialista y descolonialista. Los resultados muestran un país bajo el legado de la colonización, manifestado en el cuerpo femenino colonizado. Un cambio de paradigma es crucial en relación con las comadronas y sus pacientes. La salud reproductiva de las mujeres indígenas no mejorará hasta que esto suceda y la atención médica sea descolonizada.Palabras clave: maya, mujer, indígena, salud maternal, mortalidad, colonialism, postcolonialismo, descolonialismo, partera, comadrona.  Guatemala’s Indigenous Maternal Health Care: A System in Need of DecolonizationAbstract: Guatemala’s Maternal Mortality Ratios are the highest in Central America. These ratios vary drastically among ethnic groups, the highest occurring among rural Mayan women. As Guatemala struggles to reduce its MMRs, the controversy centers on Mayan Traditional Birth Attendants. This research investigates the role of Mayan traditional midwives within the framework of Postcolonialism. The results show a country under the legacy of colonization, manifested in the female colonized body. A paradigm shift is crucial in relation to both traditional birth  attendants and their patients. Indigenous women’s reproductive health will not improve until health care, a legacy of Colonialism, is decolonized.Key words: Maya, woman, indigenous, maternal health, mortality, Colonialism, Postcolonialism, Decolonialism, midwives.


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