Traditional birth attendants

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Abstract
In many countries 60-80% of deliveries are assisted by traditional birth attendants (TBAs). Over the last several decades efforts have been made to regulate, upgrade through training or replace the TBA. The strength of the TBA stems from the fact that she is part of the cultural and social life of the community in which she lives. Her weakness lies in the traditional practices which may have dangers for her clients. With suitable training and supervision these dangers can be minimized and her potential used to improve the health of mothers and babies. Increasingly countries are recognizing that the TBA will represent a major resource where women do not have access to services for either cultural or geographic barriers. The effective use of this resource will require an understanding and appreciation of the TBA's role and contribution by all health authorities, flexibility in the development of training programs and the co-operation of the TBAs themselves.In many countries 60-80% of deliveries are assisted by traditional birth attendants (TBAs). Over the last several decades efforts have been made to regulate, upgrade through training or replace the TBA. The strength of the TBA comes from the fact that she is part of the cultural and social life of the community in which she lives. Her weakness lies in the traditional practices which may have dangers for her clients. With suitable training and supervision these dangers can be minimized and her potential used to improve the health of mothers and babies. Increasingly countries are recognizing that the TBA will represent a major resource where women do not have access to services for either cultural or geographic barriers. An understanding of the TBA's role and contribution by all health authorities is necessary. The TBA's role is always associated with the actual birth process, but in some instances her influence extends to prenatal and postnatal period. Based on suggestions from midwives, obstetricians, anthropologists and educators, WHO has issued guidelines, encouraged consultations, and held conferences and seminars all designed to widen the acceptance of this concept and disseminate the knowledge available on both traditional birth customs and on the training needed to effectively utilize the traditional practitioners. The WHO's approach has been successful in stimulating countries to undertake TBA training and utilization programs. There is overwhelming evidence that TBAs are acceptable to the population, accessible in numbers where they are needed, capable of absorbing training, cost effective and perhaps the surest means by which maternal and infant health in developing countries can be improved. TBAs still deliver most of the world's babies and will continue to do so for many years to come. Many of WHO's Member States are now collaborating with TBAs to extend health service coverage to unserved populations.

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