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  • Title: An evaluation of the knowledge and practices of trained traditional birth attendants in Bodinga, Sokoto State, Nigeria.
    Author: Akpala CO.
    Journal: J Trop Med Hyg; 1994 Feb; 97(1):46-50. PubMed ID: 8107173.
    Abstract:
    To improve Maternal and Child Health services especially in the rural areas, a programme to train traditional birth attendants (Ungo Zoma) was established by the Sokoto State government of Nigeria in 1975. The impact of the training programme on the knowledge and practices of traditional birth attendants (TBAs) in a rural community in the state was studied. Seventy-four TBAs, consisting of 43 trained and 31 untrained attendants, were interviewed. Statistically significant differences were observed in the proportion of both groups of TBAs able to recognize high risk pregnancies and deliveries for referral to health institutions. In contrast to the trained attendants, none of the untrained TBAs offered any of the following Maternal and Child Health services: antenatal care, advice on immunization of children or their mothers during pregnancy, and family planning. Suggestions for improving the knowledge and practices of the TBAs in Sokoto as well as in other communities wishing to embark on similar programmes are offered. In Bodinga, a local government area of Sokoto State in Nigeria, a community medical doctor compared data on 43 trained traditional birth attendants (TBAs) with data on 31 untrained TBAs to evaluate Sokoto State's TBA training program by examining their knowledge and practices. Trained TBAs were more likely to identify high risk pregnant women for referral (p .001): pregnant women younger than 16 years old (74% vs. 19%) and older than 35 years old (63% vs. 16%), mothers who were of very short stature (72% vs. 0); women who had a history of antepartum or postpartum hemorrhage (77% vs. 13%), labor lasting for more than 24 hours (95% vs. 39%), abnormal lie (100% vs. 45%), and edema during pregnancy (67% vs. 19%). Even though trained TBAs were more likely to recognize high risk pregnancies, only 41% provided prenatal care. Similar proportions of both groups would refer women for postpartum hemorrhage after delivery, previous history of Cesarean section, disappearance of fetal movement during pregnancy, and retained placenta. None of the untrained TBAs provided any of the following maternal and child health services, while trained TBAs tended to do so (p .001): prenatal care, advice on immunization of mothers during pregnancy (91% of trained TBAs) and of children (82%), and advice on family planning (52%). Although trained TBAs were more likely to use new razor blades to cut the umbilical cord (58% vs. 32%), the difference was not significant. Yet, no trained or untrained TBA sterilized razor blades. 18% of trained TBAs did sterilize scissors, however, while no untrained TBA used sterilized scissors. These findings showed that the TBA training program contributed greatly to improved knowledge and practices, thereby supporting expansion and continued allocation of resources to the TBA training program.
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