ASSESSMENTS OF THE MATERNAL CARE KNOWLEDGE AND PRACTICES OF TRADITIONAL BIRTH ATTENDANTS IN IBADAN, OYO STATE, NIGERIA

Abstract

Traditional Birth Attendants (TBAs) are lay persons who attend to deliveries and concerted efforts have been made to train them. Anecdotal reports suggest that many expectant mothers patronize TBAs in Ibadan. However, there is dearth of information relating to the TBAs’ maternal care knowledge and practices. This study was therefore conducted to assess TBAs’ knowledge and practices relating to maternal care in Ibadan, Oyo State.

A cross-sectional survey of 407 out of 608 TBAs who consented to be involved in the survey, in the 11 Local Government Areas (LGAs) in Ibadan was conducted. The three categories of TBAs were; 93 local government trained-TBAs, 221 church-based TBAs and 93 TBAs who practice in herbal homes. A semi-structured questionnaire was used to obtain information on respondents’ demographic characteristics, knowledge and practices of maternal care. Knowledge and practice scores were computed with the maximum obtainable scores being 43 and 47 respectively. Data were analyzed using descriptive statistics, Independent t- test, correlation and Chi-square statistics.

Respondents’ mean age was 47.0±10.8 years, 86.0% had at least primary education and majority (84.8%) were females. Seventy-eight percent had formal TBA training; of these 63.0% reported that they were regularly supervised by skilled health workers. None of the untrained TBAs had regular supervision. Overall mean knowledge score was 79.7±20.3%. Majority (80.6%) of TBAs recognized blood pressure measurement as an essential aspect of Antenatal Care (ANC). Majority were aware of the necessity of wearing sterile gloves in taking delivery (83.0%) and prompt referral of high risk cases (76.7%). Trained TBAs had a significantly higher maternal care knowledge score compared with the untrained TBAs (p<0.05). Blood pressure measurement during ANC visits, wearing of sterile gloves, and referral of high risk cases were reported by 66.0%, 44.0% and 51.8% respectively. Trained TBAs had a significantly higher mean practice score compared to the untrained TBAs (p<0.05). A significantly higher proportion of the regularly supervised trained TBAs reported referring of high risk cases (83.8%) compared with unsupervised trained TBAs (53%) (p< 0.05). There was a poor correlation between the maternal care knowledge and practice of the trained TBAs (r=0.435, p<0.05).

The practices of untrained and unsupervised traditional birth attendants fell short of professional expectation and knowledge-practice gaps were identified among all categories of traditional birth attendants. Training and regular retraining of traditional birth attendants as well as supportive supervision by health staff of the State Ministry of Health, Local Government Area Primary Health Care departments and relevant non-governmental organizations are needed to enhance maternal care practices of traditional birth attendants in Ibadan.