Key points are not available for this paper at this time.
Diverse aspects of the training and ongoing use of the traditional birth attendant (TBA) to extend the health care system into marginal areas of developing countries are discussed. One of the most compelling reasons for giving medical training is the high number of annual deaths from neonatal tetanus (estimated in the 100s of 1000s) resulting from poor care of the cut umbilical cord. Combination of training with effective immunization programs would probably have considerable impact. Indias medically-trained and equipped TBAs duties include registering and educating pregnant women regarding proper health behaviors small family norms infant care and other issues coordinating their care and referring them to health centers for complicated medical treatments and other maternal-child health duties. A 3-week training program for training Sierra Leone TBAs which took place in 1974 is evaluated: 313 of 631 TBAs originally trained were followed up. A 4-year evaluation of a program to train TBAs in Danfa Ghana is also described. The program covered a district containing about 60000 people living in 307 villages. In 1978 a pilot program for the training of traditional birth attendants (TBAs) was begun in 2 townships in the Rangoon Division of Burma. By 1980-82 the program was extended to 19 townships and they are now being trained at a rate of 3000/year in 147 townships. Program effectiveness is studied. Area surveys of beliefs and practices connected with pregnancy childbirth and traditional midwifery are examined for Latin America and the Philippines and Western Pacific. Finally 2 general topics: TBA training program interfaces with literacy programs and the relationship between literacy and the quality of care and TBA supervision are reviewed.
Maglacas et al. (Mon,) studied this question.