Ray Alison M, Salihu H M
Department of International Health, University of Alabama at Birmingham, AL 35294, USA.
J Obstet Gynaecol. 2004 Jan;24(1):5-11. doi: 10.1080/01443610310001620206.
Traditional birth attendants (TBAs) and village midwives have been employed in many interventions to reduce maternal mortality in developing countries. This study reviews the results of 15 TBA- and midwife-based interventions that aim to improve skilled assistance in delivery and recognition and referral of complications. Outcome measures used to evaluate the impact of the programmes varied. Five of the five programmes reviewed that evaluated their impact on maternal mortality demonstrated a decline in maternal mortality ratios, two of three studies measuring morbidity-related indicators found improvement of some but not all morbidity outcomes, six of seven showed a trend of improved referral rates, and three of three found high levels of knowledge retention among trained TBAs. Programmes with the greatest impact utilised TBAs and village midwives within multisectoral interventions. These findings suggest that TBAs and village midwives contribute to positive programme outcomes. Further investigation is needed to determine the nature of their contribution within larger programmes.
在许多发展许多发展中国家，传统接生员和乡村助产士已被纳入多项旨在降低孕产妇死亡率的干预措施中。本研究回顾了15项基于传统接生员和助产士的干预措施的结果，这些措施旨在改善分娩时的专业协助以及并发症的识别和转诊。用于评估这些项目影响的结果指标各不相同。在五项评估对孕产妇死亡率影响的项目中，有五项显示孕产妇死亡率有所下降；在三项衡量与发病率相关指标的研究中，有两项发现部分而非所有发病率结果有所改善；在七项研究中有六项显示转诊率有上升趋势；在三项研究中有三项发现接受培训的传统接生员知识保留率较高。影响最大的项目是在多部门干预措施中利用传统接生员和乡村助产士。这些发现表明，传统接生员和乡村助产士有助于取得积极的项目成果。需要进一步调查以确定他们在更大规模项目中的贡献性质。
