Impact of Standardized Prenatal Clinical Training for Traditional Birth Attendants in Rural Guatemala

Abstract

In low-and-middle-income countries (LMICs), traditional birth attendant (TBA) training programs are increasing, yet reports are limited on how those programs affect the prenatal clinical abilities of trained TBAs. This study aims to assess the impact of clinical training on TBAs before and after a maternal health-training program. A prospective observational study was conducted in rural Guatemala from March to December 2017. Thirteen participants conducted 116 prenatal home visits. Data acquisition occurred before any prenatal clinical training had occurred, at the completion of the 14-week training program, and at six months post program completion. The paired t-test and McNemar’s test was used and statistical analyses were performed with R Version 3.3.1. There was a statistically significant improvement in prenatal clinical skills before and after the completion of the training program. The mean percentage of prenatal skills done correctly before any training occurred was 25.8%, 62.3% at the completion of the training program (p-value = 0.0001), and 71.0% after six months of continued training (p-value = 0.034). This study highlights the feasibility of prenatal skill improvement through a standardized and continuous clinical training program for TBAs. The improvement of TBA prenatal clinical skills could benefit indigenous women in rural Guatemala and other LMICs.

Effect of traditional birth attendants-led health education intervention on utilization of skilled birth care in West Pokot County, Kenya

“…In the study, the traditional birth attendants were trained on prenatal clinical skills and, six months post training, there was a significant increase of referrals for skilled maternal and child health services after TBAs were tasked to refer mothers for skilled birth services. 12 TBAs in the Guatemalan study, however, were allowed to perform normal deliveries in the rural areas and referred mothers with signs of complications, which was not the case in the current study where TBAs were only tasked to educate mothers on SBC, encourage and even accompany them to go for skilled hospital delivery services.…”

Study on the Knowledge Gap in Training Organized for Traditional Birth Attendants (TBAs) in Rural Guatemala and the Way for Improvement

“…Once the initial gap is addressed, there is a need to continue assessing the skills regularly. There are culturally accepted models that have been used in periodic of knowledge progress that can be utilized in these assessments, which can be modified for qualitative assessments (Hernandez et al, 2018;Carlough & McCall 2005).…”