Women's Preference for Traditional Birth Attendants and Modern Health Care Practitioners in Akpabuyo Community of Cross River State, Nigeria

Akpabio, Idongesit I.; Edet, Olaide Bamidele; Etifit, Rita E.; Robinson-Bassey, Grace C

doi:10.1080/07399332.2013.815751

Cited by 11 publications

(7 citation statements)

References 4 publications

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“…Following referrals, clients returned to TBAs as they would to a primary health care worker, such that the TBA was responsible for maternal care coordination. Client confidence in the TBA’s ability to provide quality maternal health services has been reported in other studies in Nigeria and Sierra Leone [ 16 , 17 ]. Even in studies where a higher proportion of TBA clients reported that TBAs (16%) have poor medical skills relative to skilled providers (0.5%), the majority (61%) of clients were satisfied with TBA delivery care [ 18 ].…”

Section: Discussionsupporting

confidence: 52%

“…These factors may lead to non-compliance with postnatal care referrals by TBAs. There is near-consensus over the fact that TBAs provide respectful maternal care relative to skilled health providers [ 16 , 17 , 20 , 28 – 30 ]. A synthesis of qualitative evidence from low and income countries reveals that disrespectful maternal care is a barrier to the use of facility-based delivery in many contexts [ 31 ].…”

Section: Discussionmentioning

confidence: 99%

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“Once the delivery is done, they have finished”: a qualitative study of perspectives on postnatal care referrals by traditional birth attendants in Ebonyi state, Nigeria

Chukwuma

Mbachu

Cohen

et al. 2017

BMC Pregnancy Childbirth

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BackgroundWhile 79% of Nigerian mothers who deliver in facilities receive postnatal care within 48 h of delivery, this is only true for 16% of mothers who deliver outside facilities. Most maternal deaths can be prevented with access to timely and competent health care. Thus, the World Health Organization, International Confederation of Midwives, and International Federation of Gynecology and Obstetrics recommend that unskilled birth attendants be involved in advocacy for skilled care use among mothers. This study explores postnatal care referral behavior by TBAs in Nigeria, including the perceived factors that may deter or promote referrals to skilled health workers.MethodsThis study collected qualitative data using focus group discussions involving 28 female health workers, TBAs, and TBA delivery clients. The study conceptual framework drew on constructs in Fishbein and Ajzen’s theory of reasoned action onto which we mapped hypothesized determinants of postnatal care referrals described in the empirical literature. We analyzed the transcribed data thematically, and linked themes to the study conceptual framework in the discussion to explain variation in TBA referral behavior across the maternal continuum, from the antenatal to postnatal period.ResultsDifferences in TBA referral before, during, and after delivery appear to reflect the TBAs understanding of the added value of skilled care for the client and the TBA, as well as the TBA’s perception of the implications of referral for her credibility as a maternal care provider among her clients. We also found that there are opportunities to engage TBAs in routine postnatal care referrals to facilities in Nigeria by using incentives and promoting a cordial relationship between TBAs and skilled health workers.ConclusionsThus, despite the potential negative consequences TBAs may face with postnatal care referrals, there are opportunities to promote these referrals using incentives and promoting a cordial relationship between TBAs and skilled health workers. Further research is needed on the interactions between postnatal maternal complications, TBA referral behavior, and maternal perception of TBA competence.Electronic supplementary materialThe online version of this article (10.1186/s12884-017-1616-x) contains supplementary material, which is available to authorized users.

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Section: Discussionsupporting

confidence: 52%

Section: Discussionmentioning

confidence: 99%

“Once the delivery is done, they have finished”: a qualitative study of perspectives on postnatal care referrals by traditional birth attendants in Ebonyi state, Nigeria

Chukwuma

Mbachu

Cohen

et al. 2017

BMC Pregnancy Childbirth

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“…Besides the reasons stated, evidence from other studies showed that some women have preference for traditional birth attendants [ 14 , 15 ] or delivery at home [ 16 ]. To take advantage of this perception among the women, it may be worthwhile to develop synergy between trained midwives and traditional birth attendants.…”

Section: Discussionmentioning

confidence: 99%

Patterns and determinants of dropout from maternity care continuum in Nigeria

Akinyemi

Afolabi

Awolude

2016

BMC Pregnancy Childbirth

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BackgroundThe maternal, newborn and child health care continuum require that mother/child pair should receive the full package of antenatal, intrapartum and postnatal care in order to derive maximum benefits. Continuity of care is a challenge in sub-Saharan Africa. In this study, we investigate the patterns and factors associated with dropout in the continuum of maternity (antenatal, delivery and postnatal) care in Nigeria.MethodUsing women recode file from the 2013 Nigeria Demographic and Health Survey, we analysed data on 20,467 women with an index birth within 5 years prior to data collection. Background characteristics and pattern of dropouts were summarised using descriptive statistics. The outcome variable was dropout which we explored in three stages: antenatal, antenatal-delivery, delivery-6 weeks postnatal visit. Multilevel logistic regression models were fitted to identify independent predictors of dropout at each stage. Measure of effect was expressed as Odds Ratio (OR) with 95 % confidence interval (CI).ResultsOverall, 12,392 (60.6 %) of all women received antenatal care among whom 38.1 % dropout and never got skilled delivery assistance. Of those who received skilled delivery care, 50.8 % did not attend postnatal visit. The predictors of dropout between antenatal care and delivery include problem with getting money for treatment (OR = 1.18, CI: 1.04–1.34), distance to health facility (OR = 1.31, CI: 1.13–1.52), lack of formal education, being in poor wealth quintile (OR = 2.22, CI: 1.85–2.67), residing in rural areas (OR = 1.98, CI: 1.63–2.41). Regional differences between North East, North West and South West were significant. Between delivery and postnatal visit, the same factors were also associated with dropout.ConclusionThe rate of dropout from maternity care continuum is high in Nigeria and driven by low or lack of formal education, poverty and healthcare access problems (distance to facility and difficulty with getting money for treatment). Unexpectedly, dropouts are high in South east and South south as well as in the Northern regions. Intervention programs focusing on community outreach about the benefits of continuum of maternal healthcare package should be introduced especially for women in rural areas and lower socio-economic strata.

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“…These, coupled with loss of a previous child could discourage women from adequate uptake of MHC. Favorable dispositions to patronage of traditional birth attendants may also be a factor [ 26 ]. Further research is recommended to fully understand the peculiar situation in the sub-region.…”

Section: Discussionmentioning

confidence: 99%

Death of preceding child and maternal healthcare services utilisation in Nigeria: investigation using lagged logit models

Akinyemi

Bolajoko

Gbadebo

2018

J Health Popul Nutr

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BackgroundOne of the factors responsible for high level of childhood mortality in Nigeria is poor utilization of maternal healthcare (MHC) services. Another important perspective which has been rarely explored is the influence of childhood death on MHC service utilization. In this study, we examined the relationship between death of preceding child and MHC services utilization [antenatal care (ANC), skilled attendant at birth (SAB), and postnatal care (PNC)] among Nigerian women and across the six geo-political zones of the country.MethodologyWe analyzed reproductive history dataset for 16,747 index births extracted from the 2013 Nigeria Demographic and Health Survey. The main explanatory variable was survival status of preceding child; therefore, only second or higher order births were considered. Analysis involved the use of descriptive statistics and lagged logit models fitted for each measure of MHC utilization. Association and statistical significance were expressed as adjusted odds ratio (AOR) with 95% confidence interval.ResultsThe use of MCH services for most recent births in the 2013 Nigeria DHS were ANC (56.0%), SAB (34.7%), and PNC (27.3%). Univariate models revealed that the death of preceding child was associated with lesser likelihood of ANC (OR = 0.64, CI 0.57–0.71), SAB (OR = 0.56, CI 0.50–0.63), and PNC (OR = 0.65, CI 0.55–0.69). Following adjustment for maternal socio-economic and bio-demographic variables, statistical significance in the relationship disappeared for the three MHC indicators: ANC (AOR = 1.00, CI 0.88–1.14), SAB (AOR = 0.97, CI 0.81–1.15), and PNC (AOR = 0.95, CI 0.83–1.11). There were no significant variations across the six geo-political regions in Nigeria. The likelihood of ANC utilization was higher when the preceding child died in Northcentral (AOR = 1.19, CI 0.84–1.70), Northeast (AOR = 1.26, CI 0.99–1.59), and South-south (AOR = 1.19, CI 0.72–1.99) regions while the reverse is the case in Southeast (AOR = 0.39, CI 0.23–0.60). For the Southeast, similar result was obtained for ANC, SAB, and PNC.ConclusionDeath of a preceding child does not predict MHC services use in Nigeria especially when maternal socio-economic characteristics are controlled. Variations across the Northern and Southern regions did not attain statistical significance. Interventions are needed to reverse the pattern such that greater MHC utilization is recorded among women who have experienced child death.

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Women's Preference for Traditional Birth Attendants and Modern Health Care Practitioners in Akpabuyo Community of Cross River State, Nigeria

Cited by 11 publications

References 4 publications

“Once the delivery is done, they have finished”: a qualitative study of perspectives on postnatal care referrals by traditional birth attendants in Ebonyi state, Nigeria

“Once the delivery is done, they have finished”: a qualitative study of perspectives on postnatal care referrals by traditional birth attendants in Ebonyi state, Nigeria

Patterns and determinants of dropout from maternity care continuum in Nigeria

Death of preceding child and maternal healthcare services utilisation in Nigeria: investigation using lagged logit models

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