Department of Family and Community Medicine, University of Maryland School of Medicine, Baltimore, MD, USA.
Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Glob Public Health. 2020 Oct;15(10):1522-1536. doi: 10.1080/17441692.2020.1762237. Epub 2020 May 13.
The Republic of Benin faces high maternal, newborn and child (MNCH) morbidity and mortality. Traditional birth attendants (TBAs) continue to operate on the margins of the health system yet provide critical services to women and children. This study aims to further the understanding of TBA's scope of practice for developing appropriate strategies to strengthen MNCH services at the community-level. TBAs were identified and surveyed on education, training, system support and scope of practice including management of obstetric and newborn emergencies. TBAs were found to perform diverse preventive and health promotion activities, including antenatal and newborn care counselling, promotion of family planning and immunizations. Among 109 TBAs, 11,102 births were documented in the prior year with a maternal mortality ratio (MMR) of 790/100,000 and neonatal mortality rate (NMR) 12.2/1000. The scope of TBA practices is broad and rural communities rely on this cadre for services. However, TBAs report higher rates of adverse maternal events compared to national statistics. Better understanding is needed on community preferences, training and methods of participation of TBAs within the health system. This could improve identification and referral for emergencies, reinforce safer practices and increase preventive and promotive health activities at the community level.
贝宁共和国面临着高孕产妇、新生儿和儿童（MNCH）发病率和死亡率。传统的接生员（TBAs）继续在卫生系统的边缘运作，但为妇女和儿童提供了关键服务。本研究旨在进一步了解 TBA 的实践范围，以便制定适当的战略，在社区层面加强 MNCH 服务。确定了接生员，并对他们的教育、培训、系统支持和实践范围进行了调查，包括处理产科和新生儿紧急情况的能力。调查发现，接生员开展了各种预防和促进健康的活动，包括产前和新生儿护理咨询、计划生育和免疫接种的推广。在 109 名接生员中，前一年共记录了 11102 例分娩，孕产妇死亡率（MMR）为 790/10 万，新生儿死亡率（NMR）为 12.2/1000。接生员的实践范围很广，农村社区依赖这一人员提供服务。然而，接生员报告的不良产妇事件发生率高于国家统计数据。需要更好地了解社区的偏好、培训以及接生员在卫生系统中的参与方式。这可以改善对紧急情况的识别和转介，加强更安全的做法，并增加社区一级的预防和促进健康活动。
