A co-designed conceptual educational framework for midwives to train Indigenous traditional birth attendants in low resource settings of remote Papua New Guinea

In remote Papua New Guinea there are few midwives or functioning health facilities, and high perinatal mortality. Indigenous traditional birth attendants carry the burden of caring for women and newborns. Midwives training and developing traditional birth attendants rely on ad-hoc approaches to the education they provide, drawing from their own knowledge and skills. Develop a culturally sensitive conceptual educational framework as a guide for midwives to train and supervise traditional birth attendants in low-resource settings. Seven-step approach: 1) Establish trust and respect; 2) Identification of the need; 3) Ethical considerations; 4) Needs analysis; 5) Contextual considerations; 6) Theoretical framework; 7) Practice standards. The Yamen Traditional Birth Attendant Conceptual Educational Framework guides midwives to train and supervise traditional birth attendants to strengthen maternal and newborn healthcare in low-resource settings through pre-service education and community development. Four adult, cross-cultural learning principles were identified: cultural sensitivity, strategic issues, previous experience, evidence-based practice. Expected outcomes include increased knowledge, skills, attitudes, and critical thinking of traditional birth attendants. Training and supervision of traditional birth attendants by midwives is recommended for low-resource settings of Papua New Guinea to foster strong partnerships between communities and health facilities and improve perinatal safety. A co-designed, culturally sensitive education framework is presented with the potential to strengthen maternal and newborn services in low-resource settings by linking traditional birth attendants to midwives in formal health services. Further research is needed to articulate the role, scope of work and key learning competencies.