Referral practices among traditional birth attendants and factors influencing them in Geita District

Abstract

Maternal Mortality ratio is higher in developing countries especially in Sub Saharan Africa compared to developed countries. This higher ratio is due to pregnant women missing emergency obstetric care when needed. Majority of deliveries are being conducted outside health facilities by unskilled personnel such as traditional birth attendants (TBAs). Some of the TBAs don't refer complicated cases to the health facilities and others do refer inappropriately. The referral practices among TBAs are being studied because there is limited and inconclusive information. The aim of this study was to establish the factors which influence referral practices of TBAs. The study also attempted to establish the level of knowledge of TB As on danger signs during pregnancy, delivery and post delivery. A cross sectional analytical study was done in Geita District in order to achieve the above objectives. The study population was all TBAs in Geita whereby a sample of 233 was involved in the study. Data were collected from the field and analyzed using SPSS computer software. It has been established ill this study that Most TBAs 185 (79.4%) are referring complicated cases to the health facilities however only 60% of those who are referring to the health facilities are referring appropriately. Also it has been found that factors such as training on delivery care, high level of knowledge, being supervised, high level of education, ability to read and write, not using local herbs, living close to the health facilities, improved infrastructure were associated with referring cases to the health facilities. Improvement in social conditions will be associated with improved appropriate referral from TBAs to the health facilities and thus access to emergency obstetric care (EOC) by pregnant mothers will be increased and maternal mortality ratio will be cut down. Training of TBAs should be strengthened and focused to recognition of danger signs during pregnancy, delivery and post delivery; and prompt referral of those identified cases to the health facilities.