Swiss Tropical and Public Health Institute, Basel, Switzerland.
BMC Pregnancy Childbirth. 2013 Feb 28;13:55. doi: 10.1186/1471-2393-13-55.
Traditional birth attendants retain an important role in reproductive and maternal health in Tanzania. The Tanzanian Government promotes TBAs in order to provide maternal and neonatal health counselling and initiating timely referral, however, their role officially does not include delivery attendance. Yet, experience illustrates that most TBAs still often handle complicated deliveries. Therefore, the objectives of this research were to describe (1) women's health-seeking behaviour and experiences regarding their use of antenatal (ANC) and postnatal care (PNC); (2) their rationale behind the choice of place and delivery; and to learn (3) about the use of traditional practices and resources applied by traditional birth attendants (TBAs) and how they can be linked to the bio-medical health system.
Qualitative and quantitative interviews were conducted with over 270 individuals in Masasi District, Mtwara Region and Ilala Municipality, Dar es Salaam, Tanzania.
The results from the urban site show that significant achievements have been made in terms of promoting pregnancy- and delivery-related services through skilled health workers. Pregnant women have a high level of awareness and clearly prefer to deliver at a health facility. The scenario is different in the rural site (Masasi District), where an adequately trained health workforce and well-equipped health facilities are not yet a reality, resulting in home deliveries with the assistance of either a TBA or a relative.
Instead of focusing on the traditional sector, it is argued that more attention should be paid towards (1) improving access to as well as strengthening the health system to guarantee delivery by skilled health personnel; and (2) bridging the gaps between communities and the formal health sector through community-based counselling and health education, which is provided by well-trained and supervised village health workers who inform villagers about promotive and preventive health services, including maternal and neonatal health.
在坦桑尼亚，传统助产妇在生殖和孕产妇健康方面仍然发挥着重要作用。坦桑尼亚政府提倡助产妇为产妇和新生儿提供健康咨询，并及时转介，但她们的角色不包括接生。然而，经验表明，大多数助产妇仍然经常处理复杂的分娩。因此，本研究的目的是描述：（1）妇女在寻求产前（ANC）和产后（PNC）护理方面的行为和经验；（2）她们选择地点和分娩方式的理由；并了解（3）传统助产妇（TBAs）使用的传统做法和资源，以及如何将其与生物医学卫生系统联系起来。
在坦桑尼亚姆特瓦拉地区的马萨西区和达累斯萨拉姆的伊拉拉市，对 270 多名个人进行了定性和定量访谈。
来自城市地区的结果表明，通过熟练的卫生工作者，在促进与妊娠和分娩相关的服务方面取得了重大进展。孕妇的意识水平很高，明确倾向于在医疗机构分娩。农村地区（马萨西区）的情况则不同，那里没有足够训练有素的卫生工作者和设备齐全的卫生设施，导致在家中分娩，由助产妇或亲属协助。
与其关注传统部门，不如（1）更多地关注改善获得卫生系统的机会并加强卫生系统，以确保由熟练的卫生人员提供分娩服务；以及（2）通过社区为基础的咨询和健康教育，弥合社区与正规卫生部门之间的差距，由经过良好培训和监督的乡村卫生工作者向村民提供促进和预防性卫生服务，包括孕产妇和新生儿健康。
