Training traditional midwives in Manicaland, Zimbabwe.

Sixty percent of the 60,000 annual deliveries in the province of Manicaland, Zimbabwe occur in the home under the care of a traditional birth attendant (TBA) who is a family member. A training guideline for TBAs was developed based on their knowledge and perceptions and cultural context of delivery care. Training took place at all of the health facilities providing delivery care. The nursing staff at all of these facilities were trained through workshops to be the trainers of the TBAs. The site and timing of training sessions were established to conform to the maximum convenience of the TBAs and to ensure continued follow-up and linkage with the formal health care system. Training includes the risk approach and the training materials used were only those that could be locally obtained. The training has been well received by the TBAs, the continued contact has served as a means for obtaining data on births, delivery-related morbidity and mortality. An evaluation of the impact of the program on the knowledge and practices of TBAs and the impact on health is underway.