Traditional Birth Attendants and Policy Ambivalence in Zimbabwe

Abstract

This paper analyses the importance of the services rendered by traditional birth attendants (TBAs) to pregnant women in Zimbabwe. It argues that, though an integral part of the health system, the ambivalence in terms of policy on the part of the government leaves them in a predicament. Sociocultural values as well as tradition imbue TBAs power and authority to manage pregnancies and assist in child deliveries. On the other hand, government policies expounded through the Ministry of Health (MoH) programs and policies appear to be relegating them to the fringes of healthcare provision. However, in a country with a failing health system characterized by mass exodus of qualified personnel, availability of drugs, and understaffing of healthcare centres, among others, TBAs remain the lifeline for many women in the country. Instead of sidelining them in healthcare interventions, I argue that their integration, however, problematic and often noted to be with disastrous consequences for traditional medicine, presents the sole viable solution towards achieving MDGs 4 and 5. The government and MoH should capitalize on the availability of and standing working relations of TBAs with the grassroots for better/positive maternal health outcomes. In a country reeling with high maternal deaths, TBAs' status and position in society make them the best intervention tools.

Reported Knowledge, Attitude and Practice of Antenatal Care Services among Women in Dodoma Municipal, Tanzania

“…This is an important point to be considered in every pregnancy women and as usually in high proportion of them receiving SP very late during their antenatal booking [26][27][28][29][30][31][32][33][34][35][36]. These practices were significantly associated with poor pregnancy outcome regarding intermittent presumptive treatment against malaria in pregnancy during antenatal care.…”

The role of community mobilization in the promotion of maternal health of women living with HIV in Zambia

“…Despite the largely positive characterization of TBAs in Zambia, this chapter, including chapter 2 and 3 of the dissertation have highlighted several of their limitations. Other studies from different parts of SSA also confirm these limitations (Choguya, 2014;Balogun & Odeyemi, 2010;Bergstrom & Goodburn, 2001;Harrison, 2011). Particularly, they highlight that TBAs lack advanced equipment and drugs to perfectly handle illnesses and complications that may arise during pregnancy or birth.…”

“…The mainstream narrative has traditionally reflected an embodiment of western-precipitated and 'universally optimal' solutions that usually include scaling up of 'scientific' and biomedical approaches (while ignoring local strategies and context) as a basis for improving maternal care (Choguya, 2014;Harrison, 2011). This narrative has obscured discussion on what the relevance of community mobilization has been in maternal care of HIV positive women in resource poor settings (Bolu, et al, 2007).…”

“…TBAs which have been passed on from generation to generation (Choguya, 2014;Banda, 2015;Sialubanje, et al, 2015). TBAs are characterized as useful by HIV positive women in the provision of 'soft services' that include treatment-adherence-support, provision of maternal health information, challenging stigma, discrimination and patriarchy, logistical support, nutritional and referral services to facilities.…”

“…This makes TBAs the only feasible, practical and accessible source of maternal health care. Some scholars emphasize this point by suggesting that any attempt to abandon TBAs in resource-poor settings creates a danger of wiping out the only available source of care (Choguya, 2014;Bergstrom & Goodburn, 2001;Ana, 2011;Cheelo, et al, 2016). However, questions on whether TBAs can be relevant to women living with HIV in resource-poor settings remain unanswered.…”