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  • Title: Zimbabwe's birth force.
    Author: Jacobson JL.
    Journal: World Watch; 1991; 4(4):5-6. PubMed ID: 12343752.
    Abstract:
    Traditional birth attendants (TBAs) assist with 70% of births in developing countries. Yet they often use harmful traditional practices. They often are poor. With proper training, guidance, and support, they can play an essential role in primary health care (PHC). A TBA training program begun in 1982 now operates in rural Manicaland province in Zimbabwe. It exists because, in the past, TBAs frequently used unsterilized razor blades, pieces of broken glass, or knives to cut umbilical cords which caused many neonatal tetanus deaths. They also used unhygienic practices throughout labor and delivery resulting in many maternal and neonatal deaths. Nurses teach the training course which includes hygiene, good nutrition, identification of pregnancy and associated risk factors, rest, immunizations, and safe practices for labor and delivery. Trainers try to inspire self esteem and pride in work. Since most TBAs are illiterate, techniques used to accomplish program goals include discussions, demonstrations, role plays, and songs. The program emphasizes an ongoing relationship with health workers at all levels which establishes heir pivotal role within the health care system. For example, village based maternity waiting homes for women in labor, community health workers, highly trained auxiliary midwives, and a district health center support graduated TBAs. With the inception of this training program, contraceptive usage and the number of pregnant women receiving prenatal care have risen steadily. Since pregnant women now receive PHC, such as that given by TBAs, maternal mortality has been reduced by 50% and infant mortality by 66%. Nevertheless trained TBAs often return to unsafe traditional ways and gaps in medical supplies disrupt their care. Mobile clinics and bicycles are now used to distribute training and medical supplies.
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