Obstetric complications: does training traditional birth attendants make a difference?

Area of Science:

• Maternal Health
• Public Health Interventions
• Global Health

Background:

• Traditional birth attendants (TBAs) play a significant role in childbirth in many low-resource settings.
• Assessing the impact of training interventions for TBAs is crucial for improving maternal and newborn outcomes.
• Guatemala faces challenges in accessing essential obstetric care, particularly in rural areas.

Purpose of the Study:

• To evaluate the effectiveness of a training program for traditional birth attendants (TBAs) in Guatemala.
• To determine the impact of TBA training on the detection and referral of obstetric complications.
• To assess the subsequent utilization of essential obstetric care services by women attended by trained TBAs.

Main Methods:

• A quasi-experimental design was employed with a birth surveillance system.
• Population-based data were collected from 3,518 women between 1990 and 1993.
• Key variables included geographical area, timing relative to training, TBA presence, complication detection, referral, and service utilization.

Main Results:

• The incidence of postpartum complications decreased post-intervention.
• Trained TBAs were less likely to recognize most maternal complications after the intervention.
• Referral rates did not significantly increase, but healthcare service utilization rose six-fold for women not attended by TBAs.

Conclusions:

• TBA training may positively influence postpartum complication rates and referrals.
• Evidence is less convincing regarding increased detection and utilization of essential obstetric services by women attended by TBAs.
• Further research is needed to optimize TBA training for improved maternal healthcare outcomes.