A descriptive study of the changing roles and practices of traditional birth attendants in Zimbabwe

In Zimbabwe, traditional birth attendants (TBAs) attend more than 50% of the births. Training courses to improve their skills have been offered since 1983. Although there are many assumptions about the TBAs' work, there has been little formal investigation. This is a descriptive study of the practice and attitudes of trained and untrained TBAs in Zimbabwe. Seventy-one midwives were divided into groups according to geographic area and attendance at an upgrading course. Data were obtained through informal small group interviews and observation. Findings indicate that TBAs have traditionally been both health educators and health providers. Midwives who have attended the training course exhibit improved practices, refer more high-risk pregnant women to clinics, and perceive themselves to be attending fewer births. As a result of delivering fewer babies, the TBAs believe that they have lost credibility as health educators.