Effect of traditional birth attendants-led health education intervention on utilization of skilled birth care in West Pokot County, Kenya
DOI:
https://doi.org/10.18203/2394-6040.ijcmph20241173Keywords:
Traditional birth attendants, Skilled birth care, Traditional birth attendants’-led intervention, Maternal and child healthAbstract
Background: Globally, between 2000 and 2017, maternal mortality ratio declined by 38%, with global lifetime risk of maternal death falling from 1 in 73 to 1 in 180, respectively. In West Pokot County, Kenya, over half of deliveries are managed by traditional birth attendants. The study investigated the effect of TBAs-led intervention on utilization of skilled birth care in this County.
Methods: The study employed a prospective experimental design. In the intervention arm, TBAs were recruited and trained on SBC. They were assigned expectant mothers and followed until they delivered their babies. Chi-square test was used to determine the relationship between variables. Binary logistic regression was used to compare utilization of SBC between the intervention and control sites.
Results: Majority of mothers (95%) in the intervention arm of the study went for TBAs’ services , and 79.5% of those in the control did the same. Most mothers in the intervention (81.4%) delivered in health care facility compared to 58.2% in the control (χ2=21.256, p<0.001). There was a significant difference in the odds of mothers utilizing SBC between intervention and control groups. Those in the intervention group were almost 3 times more likely to utilize SBC than those in the control group (UOR; 95% CI: 3.137; 1.909-5.155).
Conclusions: TBAs-led intervention increased utilization of SBC among mothers in the intervention compared to those in the control arm who utilized available ministry of health’s standard care.
References
Tunçalp Ӧ, Were WM, MacLennan C, Oladapo OT, Gülmezoglu AM, Bahl R, Daelmans B, Mathai M, Say L, Kristensen F, Temmerman M, Bustreo F. Quality of care for pregnant women and newborns-the WHO vision. BJOG. 2015;122(8):1045-9.
Serwanja Q, Mutisya LM, Nuwabaine L, Kamara K, Mutebi RK, Musaba MW. Continuum of maternal and newborn health in Sierra Leone: a 2019 national survey. Arch Public Health. 2022;80(1):186.
Jiang H, Qian X, Chen L, Li J, Escobar E, Story M, Tang S. Towards universal access to skilled birth attendance: the process of transforming the role of traditional birth attendants in Rural China. BMC Pregnancy Childbirth. 2016;16:58.
National Bureau of Statistics-Kenya and ICF International. Available at: https://new.knbs.or.ke/ reports/kdhs-2022/. Accessed on 20 January 2024.
Kenya Demographic and Health Survey 2022. Key Indicators Report. Nairobi, Kenya, and Rockville, Maryland, USA. Available at: https://dhsprogram. com/pubs/pdf/PR143/PR143.pdf. Accessed on 20 January 2024.
Bohren MA, Hunter EC, Munthe-Kaas HM, Souza JP, Vogel JP, Gülmezoglu AM. Facilitators and barriers to facility-based delivery in low- and middle-income countries: a qualitative evidence synthesis. Reprod Health. 2014;11(1):71.
Kenya Reproductive, Maternal, Newborn, Child and Adolescent Health. Available at: http://www.global financingfacility.org/sites/gff_new/files/documents/Kenya RMNCAH Investment Framework_March 2016.pdf. Accessed on 20 January 2024.
Anderson EJ, Chebet JJ, Asaolu IO, Bell ML, Ehiri J. Influence of Women's Empowerment on Place of Delivery in North Eastern and Western Kenya: A Cross-sectional Analysis of the Kenya Demographic Health Survey. J Epidemiol Glob Health. 2020;10(1): 65-73.
Patel AB, Simmons EM, Rao SR, Moore J, Nolen TL, Goldenberg RL, et al. Evaluating the effect of care around labor and delivery practices on early neonatal mortality in the Global Network's Maternal and Newborn Health Registry. Reprod Health. 2020;17(2): 156.
Determinants of Perinatal Outcomes among Women Seeking Antenatal Care in Selected Kisii County Level-4 Health Facilities. Available at: https://ir.jkuat.ac.ke/handle/123456789/4614?show=full. Accessed on 20 January 2024.
Gitobu CM, Gichangi PB, Mwanda WO. The effect of Kenya's free maternal health care policy on the utilization of health facility delivery services and maternal and neonatal mortality in public health facilities. BMC Pregnancy Childbirth. 2018;18(1):77.
Hernandez S, Oliveira J, Jones L, Chumil J, Shirazian T. Impact of Standardized Prenatal Clinical Training for Traditional Birth Attendants in Rural Guatemala. Healthcare (Basel). 2018;6(2):60.
Ribeiro Sarmento D. Traditional Birth Attendance (TBA) in a health system: what are the roles, benefits and challenges: A case study of incorporated TBA in Timor-Leste. Asia Pac Fam Med. 2014;13(1):12.
Kayombo EJ. Impact of training traditional birth attendants on maternal mortality and morbidity in Sub-Saharan Africa. Tanzan J Health Res. 2013; 15(2):134-42.
Fotso JC, Ambrose A, Hutchinson P, Ali D. Improving maternal and newborn care: cost-effectiveness of an innovation to rebrand traditional birth attendants in Sierra Leone. Int J Public Health. 2020;65(9):1603-12.
Oyeneyin L, Osunmakinwa O, Olagbuji Y. Incorporating traditional birth attendants into the mainstream maternal health system in Nigeria - An evaluation of the Ondo State Agbebiye programme. AJRH. 2015;35(9):290.
Alaro NL. Analysis of the Changing Role of Traditional Birth Attendants in Tirol. Texila Int J Nurs. 2018;4(2):17.
Garces A, McClure EM, Espinoza L, Saleem S, Figueroa L, Bucher S, Goldenberg RL. Traditional birth attendants and birth outcomes in low-middle income countries: A review. Semin Perinatol. 2019; 43(5):247-51.
Bucher S, Konana O, Liechty E, Garces A, Gisore P, Marete I, Tenge C, Shipala E, Wright L, Esamai F. Self-reported practices among traditional birth attendants surveyed in western Kenya: a descriptive study. BMC Pregnancy Childbirth. 2016;16(1):219.
Gitonga MM, Ngure KK, Echoka EE. Improving Skilled Birthing: Determinants and Role of a Maternal-Neonatal Health Intervention Programme in Migori County, Kenya. Researchjournali J Public Health. 2018;4(7):71.
Graham S, Davis-Floyd R. Indigenous Midwives and the Biomedical System among the Karamojong of Uganda: Introducing the Partnership Paradigm. Front Sociol. 2021;6:1-15.