Rejigging Traditional Birth Attendance – The GEANCO Effort

Paschaline, Sam and Amaka have always wondered why the pregnant women who they have been trying to help access quality delivery services at the primary health center (PHC), keep evading the health centers for the homes of the traditional birth attendants (TBA). To Paschaline and her friends working for GEANCO on the Anemia control program, the TBAs are not hygenic and professional enough to attend to the women. But the women keep testifying about the ‘better’ care they receive from the TBAs.

Three months ago, the team attended a Health Care Delivery workshop organized by Management Development Institute (MDI) in collaboration with Lagos Business School (LBS). At the end of the MDI-LBS experience, the team was asked to carry out a Community Health Intervention Program (CHIP) for their communities. It was an easy decision for Paschaline and her group to decide that repositioning the practices of the TBA was the way to go.

The Traditional Birth AttendantsThese are women who have skills in birth attendance. They inherited these skills from their mothers or learnt it by apprenticing. In traditional African community these TBAs were the accepted mid wives, and they did their work with a great sense of duty to their community and to Chukwu – God.

TBAs Today
Western medical practice has largely encroached into traditional medical practice. Many believe it is for good, whereas others bewail it as an erosion of years of sophisticated folk medical knowledge and skill. Many individuals who subscribe to the later school of thought keep choosing the traditional health care system to the orthodox practices. The population of the people who belong here is significant.

Repositioning The TBAsThe Community health intervention program of GEANCO foundation as anchored by Paschaline and her team is aimed at improving the responsiveness of the TBAs to the women who prefer their services. This is achieved through training of the TBAs and collaboration with hospitals. The key element is to reduce sepsis (infection through unhygienic practices) and to forge a referral line to expert orthodox doctors.

Summary of the CHIP Plan

The team provides support for TBAs and gives them the same support GEANCO currently gives the hospitals.  “We aim to make sure the women who use TBAs also attend antenatal with them”.

The CHIP:

  1. Trains the TBAs on emergency response, hygiene and critical danger factors
  2. Provides safe mama kits to help with hygiene
  3. Pays for the routine drugs to be used by the women
  4. Provides money for fruits and vegetables,
  5. Helps the TBAs save money -get them back to Senior CHEW –  Senior Community Health Extension Worker

“We can’t phase them out, because the women keep going back to them – if you do there will become secret and more problems happen.” –

Paschaline Chukwuka

The Trainings for the TBA will cover the following

  1. When to refer patients
  2. Infection control
  3. Basic physical examination in pregnancy –

Paschaline, Sam and Amaka are excited about their project. They are giving it all the energy they have. The overall effect is that more pregnant women now access adequate maternity care the way they most prefer – whether at the health center or at the TBA. 

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