Why TBAs are advocating for skilled birth attendants

  • MamaYe Community Super Activists at a review meeting in Lagos
Why are traditional Birth Attendants making money from delivering pregnant women of their babies, but referring their 'customers' to the hospital?

The landscape of traditional birth attendance in Nigeria is changing. In Ondo State, the government under ex-governor Olusegun Mimiko took traditional birth attendants (TBAs) completely off delivering women of pregnancies, and then helped them establish other trades. In Lagos State, the overall intention is safe delivery of newborns, regardless of the place of the delivery, but with adequate mechanism to ensure compliance with standards of operation.

The Lagos State example may be responsible for why some TBAs that have become members of MamaYe Lagos State Super Activists are now encouraging pregnant women to patronise healthcare facilities to be delivered of their babies.

In Ondo State, referring pregnant women to the hospital was compulsory for TBAs. They were rewarded with vouchers that earned them 2,000 Naira per referral. Failure to refer pregnant women to the hospital became a criminal offence. For Lagos, TBAs are immersed into the safe delivery of pregnancies. They must however register to continue practicing or face a fine or a jail term.

As TBAs are being empowered for improved services, one would wonder why some of them would still encourage pregnant women, who are their ‘customers’, to patronise public health facilities.

Princess Adejumoke Adediran is a TBA from Alimosho. She is also a MamaYe Super Activist. During a MamaYe Review Meeting with Super Activists in Lagos, Princess Adejumoke, in the midst of her fellow activists reported on how she started encouraging other TBAs on the importance of health facilities and skilled birth attendance for pregnant women. She also said that she encouraged pregnant women to patronise the primary healthcare centres in their communities.

Of course, the TBAs and, especially the pregnant women, were surprised that such encouragement came from Adejumoke, because people at the community level believe in the TBAs more than modern medicine and the so called ‘skilled’ birth practice.

But two factors encouraged the princess on her choice. The first was the immersion programme that the Lagos State government introduced, while the second was the encounter she had with MamaYe, a campaign that encourages everyone to take action to ensure that pregnant women survive.

Princess Adejumoke’s colleague, Olayinka Erinle from Ojo Local Government of Lagos State has also started to inform pregnant women and other TBAs on the importance of attending antenatal care and patronising the hospital to give birth.

Olayinka said that it became important for TBAs to support the Lagos State government in its quest to immerse them in the modern methods of helping pregnant women and newborns. They would acquire new skills and be able to attend to pregnant women better.

Also, the new knowledge around danger signs in pregnancy, importance of blood donation and skilled birth attendance for pregnant women that the 2 TBAs gained from being MamaYe Super Activists was an eye opener to the dangers that surround their unskilled practice.

Data from page 22 of The Confidential Enquiry into Maternal Deaths in Ondo State (CEMDOS) 2012/2013 shows that most maternal deaths occurred in public health facilities. However, in true sense, TBAs push pregnant women out of their domains when they experience uncontrollable situations like tear or excessive bleeding. Many of such pregnant women die in the hospital due to complications that are too late to manage, or even die before getting to the hospital.

Olayinka took her MamaYe campaign to charcoal sellers association of 48 members. She discussed the importance of blood donation, antenatal care attendance and skilled birth delivery with them. She also spoke at a TBA meeting with 32 TBAs on how to cooperate with the government on encouraging pregnant women to patronise health facilities. She recruited 9 new activists to join her in the activism for maternal and newborn health.

Princess Adejumoke, who also spoke at a TBA meeting in her community, encouraged them and other women on blood donation, family planning and facility-based delivery. She got 5 volunteers to join her in her activism.

Twenty-eight (28) other MamaYe Super Activists also gave reports on how they took the campaign to various meetings, met various community people, youths and religious leaders and got more volunteers for the maternal and newborn health improvement in Lagos State.

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