Why not incooporate Traditional Birth Attendants?

"Traditional Birth Attendants" (TBA)doesn't seem a very friendly term in regard to Maternal Newborn and Child Health in the modern day. The picture of a "traditional" Birth attendant displays unhealthy conditions and  risks for both the newborn and the mother.The term traditional may be stigmatizing already for both the practitioners and their clients.

A tug-war has been raging between the government and the TBAs with the former feeling that TBAs are a health danger to their clients.While this may be so, we need to appreciate the fact that stamping out the TBA practice may not be as easy as is expressed.

Perhaps a closer look at the factors contributing to the high rate of TBA deliveries in the community would enlighten the government on the measures to take. TBAs may not  be necessarily an old woman in the village who has no information on hygiene.It could b a young woman who can be trained and empowered to help emergency delivery cases in the community and who know the appropriate action to take whenever the life of a client is threatened.

In a recent press interview,Dr. J.M Kiragu a Nairobi obstetrician said that TBAs are a fundamental part of the health platform. He said that the traditional practitioners handle a bulky bit since there are many successful deliveries performed by TBAs. "Empowering them would be the most appropriate thing to do in order to make the them a bridge between the health facilities and the community"

But an expectant mother noted that the health facilities were expensive and the health workers unfriendly. "The traditional attendants are kind and not expensive and when there are no complications,the delivery is as good as the one done in hospitals" she said.

The integration of TBAs  in health facilities is an issue that need redress. Given the right tools, the TBAs are able to disseminate information to their clients and know how to protect themselves, their clients and the lives of many unborn babies.

HIV Stigma still rife in Health Facilities

 In every workshop, fellowship or HIV related forum the story goes as: "stigma is a thing of the past!" But reports from Comprehensive Care Centers have a different story. Stigma is rife in health facilities though the least expected.

This has had enormous effects on the enrollment of expectant mothers in the Comprehensive Care Centers (CCC) for fear of being embarrassed by health workers or their HIV status being exposed. In an interview, a CCC client had this to say: " I have to travel more than 3km to get a more friendly center where the health workers don't intimidate me."

Some health workers have been reported to abuse the dignity and rights of People Living with HIV by asking embarrassing questions such as why PLWA choose to get pregnant. This abuse has prompted many HIV+ mothers to decline to attend the Anti natal clinics and they end up delivering their babies at home.
The question of the mushrooming Traditional Birth Attendants seems to have an answer in as much as many government medical officers decry the practice.

The three parties however need a consensus. This is in an effort to stop further transmission where the TBAs are at a risk of getting infected while in their practice and the medical officers making appropriate use of the TBAs. The client needs proper sensitization to enable them know the importance of disclosure and how to adress abuse from health facilities.
The battle against stigma rages on but a change of weapons may do some trick!