Abstract:
Background: In many low-income countries, formal post-partum care utilization is much lower than that of skilled
delivery and antenatal care. While Traditional Birth Attendants (TBAs) might play a role in post-partum care, research
exploring their attitudes and practices during this period is scarce. Therefore, the aim of this study was to explore
TBAs’ practices and perceptions in post-partum care in rural Tanzania.
Methods: Qualitative in-depth interview data were collected from eight untrained and three trained TBAs. Additionally,
five multiparous women who were clients of untrained TBAs were also interviewed. Interviews were conducted in
February 2013. Data were digitally recorded and transcribed verbatim. Qualitative content analysis was used to
analyze data.
Results: Our study found that TBAs take care of women during post-partum with rituals appreciated by women. They
report lacking formal post-partum care training, which makes them ill-equipped to detect and handle post-partum
complications. Despite their lack of preparation, they try to provide care for some post-partum complications which
could put the health of the woman at risk. TBAs perceive that utilization of hospital-based post-partum services among
women was only important for the baby and for managing complications which they cannot handle. They are poorly
linked with the health system.
Conclusions: This study found that the TBAs conducted close follow-ups and some of their practices were appreciated
by women. However, the fact that they were trying to manage certain post-partum complications can put women at
risk. These findings point out the need to enhance the communication between TBAs and the formal health system
and to increase the quality of the TBA services, especially in terms of prompt referral, through provision of training,
mentoring, monitoring and supervision of the TBA services.
