New role for traditional birth attendants, Saturday, March 27, 2010, (pg 19)

With effect from 2015, more than 10,000 traditional birth attendants (TBAs), will not be allowed to handle deliveries because of their inability to handle complications which lead to maternal mortality.
Rather, they will be trained to provide information on proper antenatal care, support family planning initiatives and educate expectant mothers on the need to attend health facilities.
The decision was taken jointly by the Ghana Health Service (GHS) and the World Health Organisation (WHO) as part of measures to ensure that Ghana meets targets 4 and 5 of the Millennium Development Goals (MDGs).
The Reproductive Health Co-ordinator of the GHS, Dr Patrick Kuma-Aboagye, who made this known to the Daily Graphic admitted that even though phasing out the TBAs remained a big challenge, it was necessary if the country was to meet the targets of the Millennium Development Goals (MDGs) 4 and 5.
The MDG 4 is to reduce child mortality by two-thirds, between 1990 and 2015, while MDG 5 is to reduce maternal mortality by three-quarters between 1990 and 2015.
Dr Kuma-Aboagye further explained that the policy was intended to ensure that only skilled healthcare personnel conducted deliveries throughout the country in safe hygienic and well- resourced health facilities.
“After many years of trials with the TBAs there was a realisation that the things that kill women during child birth were beyond the capability of the TBA.” Dr Kuma-Aboagye explained.
Dr Kuma-Aboagye was, however, quick to add that the TBAs would be re-oriented to provide services other than deliveries.
According to Dr Aboagye, “the current policy is that we train and support TBAs but not in the whole country. Any district that has a lot of women delivering but the number of midwives are not adequate are at liberty to train and support the TBAs.”
He added that the focus now would be to increase the number of midwives in the system in addition to more health facilities.
According to the WHO, almost four million new-borns die before the first month each year and a similar number are stillborn. In addition, over half a million mothers die each year as a result of childbearing with the vast majority of the deaths occurring in under-resourced settings.
Ghana like many African countries has high infant and maternal mortality, particularly in rural areas where access to health care is limited.
From the 1970s, the country trained more than 10,000 TBAs to assist in health promotion and in the basics of safe delivery and referral.
A report launched by the Africa Science Academy Development Initiative (ASADI) in the country, last year indicated that about 560 children die per 100,000 births.
The report recommended giving new-born babies a healthy start, preventing and managing infections in new-borns and young children and making childbirth safe as some of the means to reducing child and maternal mortality in the country.
Commenting on the GHS decision, a renowned international consultant on family health, Prof Fredrick T. Sai observed that the period when TBAs were the backbone of the deliveries for women was long past as scientific evidence points to the fact that dependence on traditional birth attendants as opposed to the trained scientific personnel had created a lot of problems.
He said even though TBAs were an essential part of health delivery in the country, the only danger they posed was that some of them did not know their limitations. “They do not know when danger is approaching hence the need to refer the patient to a scientific facility”.
He cautioned that the TBAs could not be thrown out of the country’s health system overnight because they could be useful as helpers of the health service that could come between pregnant women and health care.

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