Perspective of Traditional Birth Attendants on Their Experiences and Roles in Maternal Health Care in Rural Areas of Northern Ghana

Abstract

Background Traditional birth attendants play significant roles in maternal health care in the rural communities in developing countries such as Ghana. Despite their important role in maternal health care, there is paucity of information from the perspective of traditional birth attendants regarding their role on maternal health care in rural areas in Ghana. Objective The aim of this study was to explore and describe the role of traditional birth attendants in maternal health care in the rural areas in Ghana. Methods A qualitative explorative approach was adopted to explore the role of traditional birth attendants in maternal health care in the rural areas of Ghana. Ten (10) out of a total of twenty-seven (27) practising traditional birth attendants in the study area were purposefully selected from five (5) rural communities in the Bongo District of Ghana for the study. Data were collected through in-depth, unstructured, individual interviews using a guide. Data collected from the interviews were transcribed verbatim and analysed to identify themes. Results Six main roles of traditional birth attendants on maternal health care in rural areas were identified in this study: traditional birth attendants conduct deliveries at home, they provide health education to women on nutrition during pregnancy and lactation, they arrange means of transport and accompany women in labour to health facilities, they provide psychological support and counselling to women during pregnancy and childbirth, and traditional birth attendants are not paid in cash for the services they render to women in the rural areas. Conclusion Our study brought to light the critical role traditional birth attendants play in maternity in rural and remote areas in Ghana. There is a need for skilled birth attendants to collaborate with traditional birth attendants in rural and deprived communities to provide quality and culturally accepted care in the rural communities.

“I couldn’t buy the items so I didn’t go to deliver at the health facility” Home delivery among rural women in northern Ghana: A mixed-method analysis

“…The findings also affirm the existing documentation that some women in SSA use health facilities for ANC but go on to deliver at home where SBAs are more likely to be absent [13,32]. Notwithstanding, we believe that among other maternal health interventions in the study area, the re-orientation of TBAs in the Upper East region of Ghana to referring or accompanying pregnant women to the health facilities to deliver, instead of conducting the deliveries themselves, might have contributed to the relatively lower proportion of home deliveries noted in this study [33,34].…”

Examining the roles of significant others of women in the uptake of health facility delivery in Northern Uganda: perspectives from the health belief model.

“…Majority of the significant others of women cited the need for mothers to go to a health facility to minimize the occurrence of -or-severity of maternal and child health negative outcomes. As cited from prior studies, some felt that they could rely on the knowledge and expertise of TBAs to help them detect a birth-related complication requiring the intervention of a health expert [16,17]. This assumption was found from previous studies to be misleading as it exposes the mother to the likelihood of experiencing adverse negative outcomes (such as; death, loss of the baby, psychological stresses, among others) because of the delays between transferring the mother from the TBA's place to the health facility, as most women are referred in poor clinical state [18].…”

Exploring the reasons why women prefer to give birth at home in rural northern Ghana: A qualitative study

“…The World Health Organisation (WHO) de nes a traditional birth attendant as "a person who assists the mother during childbirth and initially acquired her skills by delivering babies herself or through apprenticeship to other traditional birth attendants" [9]. Traditional Birth Attendants (TBAs) continue to play a signi cant role in assisting childbirth care services, particularly in rural areas of Ghana [10]. The recent maternal health statistics from Ghana Health Service 2016 report shows that more than 80% of pregnant women had at least one contact with a skilled provider during pregnancy and only 56.2% of deliveries were attended by skilled birth attendants [11].…”

“…Previous studies have shown that in Ghana, women, traditionally prefer to deliver at home because it is cheaper, and easier as women who deliver at home receive social support from their extended families and do not have to pay much for the delivery services [10,12,13]. Other studies [14][15][16][17] indicate that lack of nancial or economic resources, transportation, and delivery of supplies, lack of coordination and referral between Traditional Birth Attendants at the community level and facilities can all inhibit women from using facility-based services.…”