Community perceptions towards the new role of traditional birth attendants as birth companions and nutrition advocates in Kakamega County, Kenya

Abstract

Delivery with skilled birth attendants is important for reducing maternal mortality in developing countries. However, traditional birth attendants (TBAs) are abundant in such settings, managing deliveries without the skills and resources necessary to prevent mortality in this situations. Interventions that have been proposed to mitigate the situation include redefining the role of TBAs to nutrition advocates and birth companions for pregnant women to health facilities. We thus explored community perceptions on these new roles of TBAs, as birth companions and nutrition advocates, and their influence on health facility deliveries in Kakamega County, Kenya. Qualitative data was collected through key informant interviews with health workers and focus group discussions with lactating mothers, pregnant women, husbands, community leaders, community health volunteers, and TBA. Content analysis was conducted; data was organized into subthemes and conclusions made from each subtheme using Atlas.ti software. TBAs adopted their birth companion role as the majority offered companionship to mothers delivering at health facilities. Mothers were happy with this role as TBAs continued providing companionship even after delivery. The community members were happy with the new role of TBAs and reported increased deliveries at the health facilities. In contrast, TBAs did not adopt the nutrition advocacy role sufficiently. We found that redefining the role of the TBAs into birth companions to support facility-based delivery is thus feasible and acceptable. Nutrition advocacy by the TBAs should be strengthened to maximize on the opportunity provided by the close association between TBAs and mothers and the community.

Design and implementation of a health systems strengthening approach to improve health and nutrition of pregnant women and newborns in Ethiopia, Kenya, Niger, and Senegal

“…In conjunction with MoH, we developed a guideline for reorienting TBAs as birth companions that describes the reorientation process, implementation of new roles, and recognition of TBAs. A manuscript describing the community perceptions towards the new role of TBAs as Birth Companions and Nutrition Advocates in Kakamega County, Kenya will be printed in this journal supplement (Anono et al, ). The programme utilized WHO's “Near Miss” form to monitor quality of delivery services.…”

The Relationship Between Attendance of at Least Four Antenatal Care Visits and Facility Delivery

“…This is an indication that there is still a lot of work to do to improve maternal health services provision in rural areas to ensure there is increased demand for institutional delivery. Concerning the distance to the health facility, the literature points out among the major demand factors for health services known to cause obstacles, if the distance is long, but also a source of increased demand for health services if the distance is short (59)(60)(61). Economically, the majority of urban residents have access to opportunities that present them with sources of income to be in a position to afford.…”

Desire for Birth Companionship Among Pregnant Women Attending Antenatal Care in Debremarkos City, Northwest Ethiopia: Magnitude and Associated Factors

“…The possible explanation for this higher desire for birth companionship during labor and delivery in this study might be that the majority of women in our study had no formal education and those participants need the nearest person for communication-related health facility services. There is evidence that shows women who live in the marginalized area of Ethiopia with limited educational level are highly experiencing traditional birth attendants, and even they need to make them as companion at the health facility ( 32 , 33 ). The finding of this study also higher than study conducted in Arba Minch Ethiopia (43.7%) ( 12 ), Kenya (37%) ( 9 ), Nigeria (22.1%) ( 34 ), and Tanzania (44.7%) ( 11 ).…”