Perceived differences on the role of traditional birth attendants in rural Tanzania: a qualitative study

Abstract

Background In many low to middle income countries, traditional birth attendants (TBAs) play various roles (e.g., provision of health education, referral to hospitals, and delivery support) that can potentially improve women’s access to healthcare. In Tanzania, however, the formal healthcare systems have not acknowleded the role of the TBAs. TBAs’ contributions are limited and are not well described in policy documents. This study aimed to examine the perspectives of both TBAs and skilled birth attendants (SBAs) to clarify the role of TBAs and issues impacting their inclusion in rural Tanzania. Methods We used a qualitative descriptive design with triangulation of investigators, methods, and data sources. We conducted semi-structured interviews with 15 TBAs and focus group discussions with 21 SBAs in Kiswahili language to ask about TBAs’ activities and needs. The data obtained were recorded, transcribed, and translated into English. Two researchers conducted the content analysis. Results Content analysis of data from both groups revealed TBAs’ three primary roles: emergency delivery assistance, health education for the community, and referrals. Both TBAs and SBAs mentioned that one strength that the TBAs had was that they supported women based on the development of a close relationship with them. TBAs mentioned that, while they do not receive substantial remuneration, they experience joy/happiness in their role. SBAs indicated that TBAs sometimes did not refer women to the hospital for their own benefit. TBAs explained that the work issues they faced were mainly due to insufficient resources and unfavorable relationships with hospitals. SBAs were concerned that TBAs’ lacked formal medical training and their actions could interfere with SBAs’ professional work. Although there were no between-group interactions at the time of this study, both groups expressed willingness to collaborate/communicate to ensure the health and lives of mothers and babies. Conclusions TBAs and SBAs have different perceptions of TBAs’ knowledge and skills, but agreed that TBAs need further training/inclusion. Such collaboration could help build trust, improve positive birth experiences of mothers in rural Tanzania, and promote nationwide universal access to maternal healthcare.

Factors Associated with Use of Traditional Birth Attendants for Child Delivery: A Cross-Sectional Study

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Intersectionality and Dependency Lenses in Neonatal Mortality: Evidence of Regional, Residential, and Socioeconomic Inequalities from Post-colonial Tanzania, 1991–2016

“…Nevertheless, differences between extreme poverty in large regions like Dar es Salaam and rural areas manifest inequality differently (intersectionally). For example, neonatal mortality in large, urbanized regions may be exacerbated by a lack of traditional midwives who assist rural women in the hinterlands when giving birth (Shimpuku et al 2021). Traditional birth attendants have been shown to significantly lower stillbirths, neonatal, and perinatal mortality (Shimpuku et al 2021).…”

Associated factors for multidimensional attitudes and behaviors of reproductive health toward pregnancy among early and late adolescents in Tanzania: a cross-sectional study

“…Data were collected in all 41 primary and 13 secondary schools in three wards of Korogwe District, an area in Northeast Tanzania [14]. These three wards were selected from rural, urban, and middle, respectively to make a representative population in Korogwe District.…”