A study to determine community knowledge and perception towards trained traditional birth attendants in Siavonga District

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Himwiila, Lucensia
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The aim of this study was to determine community knowledge and perception towards trained TBAs in Siavonga District.The literature reviews of relevant studies revealed that TBAs have little or no impact on maternal and newborn mortality rate. A lot of births in developing countries, especially in remote areas, take place at home and despite the presence of trained TBAs most women in rural areas still prefer assistance by traditional birth attendants (African Journal, 2008).However, TTBAs remain the only source of maternal and newborn health care in communities devoid of access to health facilities. Unless the issues of social, societal and hidden causes of poor health of women are addressed the idea to improve health of women and new born in developing countries is quite far fetched (Asghar, 1999). It is for this reason that the study was conducted to assess community levels of knowledge and perception resulting in low utilization of TBAs. A Qualitative study design was used. This study design has been found appropriate because the study topic is of practical concern to the community, and members of community feel that they should have equal participation in planning and implementation of research. The study was conducted in Siavonga District and the study population comprised men and women residing in the study area. A pilot study was conducted in Monze District prior to the main study to test the data collecting instrument. A focus Group Discussion (FGD) guide was developed and used to collect data. Stratified sampling procedures were used to select FGD participants. Men and women who were willing to take part in the study were randomly selected from each stratum. Two FGDs were conducted during pilot study and five FGDs during the main study. A total of seven FGDs with 8 to 10 participants were conducted. Three groups with men, three groups with women and one group with Headmen. All the participants were married and were aged between 19 and 39 years of age. The FGD were conducted in quite room far from any disturbances.Qualitative data derived from FGDs were analyzed using principles of contents analysis. This entailed reading, rereading and vigorous study of each question to come up with concept in the responses through process of coding. Notes and observations were sorted into categories representing different ideas or themes. All similar ideas and impressions were written down according to themes. The following Five themes were identified:(i)Knowledge about trained TBAs (ii)Knowledge on health problems (iii)Access to trained TBAs (iv)Cultural values and (v)Attitude. The study revealed that the community members were aware of the presence of trained TTBAs in their community and were aware of their functions. All participants in the five FGDs were knowledgeable about the common health problems of pregnancy and labour such as: swelling of feet, hands and sometimes face, bleeding during pregnancy, labour and after delivery. They observed that these problems were made worse by lack of transport to take mothers to the nearest health facility, long distances to health facilities and at the same time aggravated by poor health of women. The participants revealed that trained TBAs were appreciated but accessibility was hindered by poverty, distance, illiteracy and cultural beliefs. Although the community showed a positive attitude towards trained TBAs, they Were not supporting them, this made their work difficult.The major recommendations were: 1.The District Health Management Team should reduce the catchments population for trained TBAs by changing the measure of number of population to distant, with a maximum distance of 3 kilometer in diameter for remote areas where households are spaced; to enable accessibility to trained TBAs by the community. 2.The community in the rural areas to be sensitized on the need to support the pregnant women who developed problems during antenatal, labour and delivery and to refrain from bad cultural practices that are detrimental to their health. 3.The District Health Management Team (DHMT) should ensure that supportive services such as referral systems and qualified staff are available within reach, for trained TBAs to function effectively. 4.The community to provide support for trained TBAs to enable them to function effectively.