Changing Roles of Traditional Birth Attendants

Female Genital Mutilation
By Mufutau Adewole Olaleye
Staff Writer – IslamOnline.net

Traditional Birth Attendants, TBAs have been valuable members of the birthing process, long before the advent of modern medicine, and its institutions. Their role has served women in the diagnosis of pregnancy, along with prenatal and post natal care. Unlicensed, they still provide a valuable service in many developing countries, which access to modern medical treatment is far from the rural areas or the cost of which is prohibitive for those who cannot afford modern medical care.


In Nigeria, TBAs  still have a large impact on the health of the mother and child even in this modern life, as the introduction of  modern health services has not eradicate the function that they serve, especially in rural areas. It has been customary for the expectant mother to register with a local TBA to facilitate easy birth, and to avoid Illegal fees, bribes, unreliable transport and un-cooperative drivers; poor and uncomfortable roads; lack of drugs and essential supplies, and negative staff attitudes.


Recently, one of the functions of TBAs was to facilitate female genital mutilation, FGM. 

Traditional birth attendant (TBA) as a person who assists the moth er at childbirth and who initially acquired her skills delivering babies by herself or by working with other birth attendants.

FGM has now been halted by some state governments in Nigeria, which up till this day has not been outlawed by the federal constitution. It was through the persuasion of some NGOs in collaboration with the United Nations Population Fund (UNFPA), that changes have begun to take place. Chief Aderibigbe, is a TBA who has previously carried out female circumcision on many girls.  It was Aderibigbe and his colleagues who called on TBAs to stop female genital mutilation (FGM). Among the southwestern states, Osun State has the highest prevalence rate which according to statistics is as high as 87%.


Where There Is No Doctor


In Lagos state a mother of four who claimed anonymity has advised the government to furnish TBAs who are also known as traditional midwives (TMs), with latest information about health and how to use hygienic tools for the birthing process. Her argument was that people are not ready to leave what they believe is their tradition. She also emphasized:


''… that the users and non users of native doctors would not like them to be banned because of the importance of their role in Nigerian rural life where there is no doctor - as we know that the importance of health is huge.''


A Healthy Nation is a Wealthy Nation  


If we go by the 2005 report on maternal mortality released jointly by WHO, UNICEF, 

 TBAs occupy a prominent position in Nigeria today as between 60-85 per cent of births delivered in the country and especially in the rural communi ties are by the TBAs.

UNFPA (United Nation Population Fund) and the World Bank, in Nigeria alone, up to 59 000 women may have died nationwide in cases related to maternity. One of out every 18 deliveries carries the risk of death and a whopping 1,100 deaths were estimated from 100 000 live births. This is of course huge and alarming if the parameters used at arriving at these estimates are dependable. Nigeria was conspicuously missing from the list of countries with good death registration and good attribution of cause of death.

Another TBA (to remain unnamed) in Ayetoro, Yewa North of Ogun State, has said that their association is ready to cooperate with government if the later is ready to assist the TBAs in training courses and not to prohibit their activities. He also emphasized that many TBAs are do their job well, and needed to be respected as literates because literacy is not only about holding degrees, but it is also about being perfect in your field.


''Most of my patients are women who are very poor and might be under nourished, so they cannot afford expensive medical care. But I do a good job using herbs and I have been trying my best to make people stop female genital mutilation," he said.

Reconstructive surgery is known to be remedy to 90 percent of uncomplicated cases in Nigeria but the surgery requires trained staff and professionalism. The average cost of treatment and two weeks of post-operative care is $300 -- a fortune for most women in developing countries.


Chief Bisi Omidusy, vice-chair of a group of birth attendants .

Now, the role of TBA's who come under this new UNFPA program will be to assist health care professionals by educating the people about the ills of FGM, to provide advice and to dispense basic medicines. The government should try to find all possible ways to make them discharge their profession in more proper way without being marginalized, and to let them know the benefits and harmful aspects of using herbal medicine to treat complications of pregnancy and other related diseases. They should also assist in low risk births and natural delivery, especially as they are still needed in remote rural areas.


Adesina, S.K. Traditional Medical Care in Nigeria
Related Links:
UNFPA Support to Traditional Birth Attendants
W.H.O. Global Action for Skilled Attendants for Pregnant Women
Mufutau Adewole Olaleye is a Nigerian Newscasting editor and translator at Voice of Africa, Radio Cairo.

Add comment

Security code