Perspectives in Primary Care: The Trained Traditional Birth Attendant: a Study of Her Role in two Cultures

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Abstract
The training of the traditional birth attendants in the national programme in Liberia and in the innovative health programme of RUHSA in south India has been evaluated. There has been an improvement in coverage with prenatal care and immunization with tetanus toxoid associated with a fall in the incidence of low birth weight and neonatal tetanus. The need for repeated refresher courses, for effective back-up in case of emergencies, and for close supervision to prevent risk-taking is stressed. Even though the performance of the trained traditional birth attendants (TTBA) improved with regard to the assessment of pregnancy and the identification of risk factors, the TTBA tended to handle complicated births, retained placenta, and prolonged labour by themselves. Whatever the reasons, it stresses the need for the supervisory back-up services to work closely with the TTBA.

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