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THE PRACTICE OF TRADITIONAL BIRTH ATTENDANCE AND THEIR IMPLICATIONS ON THE HEALTH OF PREGNANT MOTHERS IN UZENEMA UROMI EDO STATE

Abstract

This study investigated the role of traditional birth attendants (TBAs) in maternal health outcomes within Uzenema Uromi, aiming to understand the practices employed by TBAs and their influence on the health of mothers during childbirth. A cross-sectional survey research design was adopted to gather comprehensive data, utilizing a structured questionnaire administered to a sample of 133 respondents, including both pregnant mothers and traditional birth attendants. The analysis employed frequency tables, simple percentages, means, and standard deviations to summarize the data, while t-tests were conducted to evaluate the hypotheses formulated for the study. The findings revealed that a significant proportion of respondents recognized the positive impact of TBAs on maternal health, with 94.7% agreeing that the practices utilized by these attendants were beneficial. Cultural beliefs and the accessibility of TBAs were identified as primary motivators for pregnant mothers seeking their services over formal healthcare options. Additionally, the analysis highlighted the necessity for collaboration between TBAs and formal healthcare providers to improve maternal health services. The t-test results confirmed a significant relationship between TBA practices and maternal health outcomes, indicating that these traditional practices play a critical role in enhancing the well-being of mothers during childbirth. Despite these encouraging findings, the study acknowledged limitations such as the focus on a single geographical area, which may limit the generalizability of the results to other regions. The reliance on self-reported data also raised potential biases that could affect the validity of the findings. The study concluded that integrating traditional birth practices with modern healthcare services could further enhance maternal health outcomes in Uzenema Uromi. To address the identified issues, the study recommended the implementation of awareness programs to educate pregnant mothers on the benefits and risks associated with traditional and formal healthcare services, empowering them to make informed decisions about their childbirth options. Additionally, establishing training programs for TBAs was suggested to equip them with knowledge and skills aligned with modern healthcare practices, thus improving the safety and effectiveness of their services. Furthermore, the study called for the development of frameworks that facilitate collaboration between TBAs and healthcare providers, promoting a comprehensive approach to maternal healthcare. Future research was also encouraged to explore healthcare providers’ perspectives on traditional birth practices and to assess the long-term impact of integrated healthcare services on maternal and neonatal health outcomes. By broadening the geographical scope of future studies, researchers could gain a more comprehensive understanding of traditional birth practices and their implications across diverse cultural contexts.

 

CHAPTER ONE

INTRODUCTION

1.1 Background to the Study

In many developing countries, traditional birth attendants (TBAs) play a critical role in maternal health care. These practitioners are often deeply rooted in cultural practices and community structures, providing essential services, particularly in rural and underserved areas where access to formal healthcare facilities may be limited. In Uzenema Uromi, Edo State, traditional birth attendants have historically been the primary caregivers for pregnant women, offering support during childbirth and postnatal care (Bukar & Jauro, 2023). Their presence is significant, as they are trusted members of the community who understand the local customs and beliefs that surround childbirth, which often influences the decisions women make regarding their maternal health.

The practice of traditional birth attendance is characterized by the use of local knowledge, skills, and cultural beliefs surrounding childbirth. TBAs often rely on their experience and intuition to assist women during labor and delivery, offering a comforting presence that many women find invaluable. However, while TBAs can provide emotional and social support to mothers, their practices can also lead to significant health implications, both positive and negative (Agbo, 2023). For instance, the reliance on traditional methods and beliefs can sometimes conflict with modern medical practices, leading to complications that could have been prevented with professional healthcare intervention. As such, the gap between traditional practices and medical training can have critical consequences for maternal and newborn health.

Issues such as inadequate training, lack of access to sterile equipment, and limited understanding of obstetric complications can pose risks to the health of mothers and newborns (Balogun & Odeyemi, 2020). While TBAs often have a wealth of experience, the absence of formal training in obstetrics can hinder their ability to recognize and manage complications effectively. This reality is compounded by the challenges faced in accessing modern healthcare facilities, which can lead to a reliance on TBAs even in high-risk situations. The health system’s inability to adequately support these practitioners further exacerbates the situation, leaving many women vulnerable during pregnancy and childbirth.

Recent efforts by the Nigerian government and various health organizations aim to improve maternal health outcomes by integrating traditional practices with formal healthcare systems (Ebuehi & Akintujoye, 2022). These initiatives often focus on training TBAs to recognize when to refer patients to higher levels of care and ensuring they have access to basic medical supplies. The integration of TBAs into the formal health system seeks to harness their local knowledge while simultaneously addressing the deficiencies in training and equipment. This collaborative approach aims to create a more comprehensive maternal healthcare system that benefits both TBAs and the women they serve.

However, the effectiveness of these interventions in Uzenema Uromi remains underexplored, necessitating a focused examination of TBAs’ roles, practices, and their implications for maternal health in the region (Ekanem et al., 2020). Understanding how TBAs operate within their communities and how they can be effectively integrated into the formal healthcare system is crucial. This exploration will provide insights into the barriers and facilitators of maternal health services in the area, which is essential for developing targeted interventions that can enhance maternal health outcomes.

The socio-cultural context of Uzenema Uromi significantly influences the practices of TBAs. Their role is often seen as a bridge between traditional and modern healthcare practices, and their acceptance within the community can enhance the uptake of maternal health services (Imogie et al., 2022). In many cases, women prefer to deliver with TBAs due to the familiarity and comfort they provide. This preference highlights the importance of understanding the cultural dynamics at play in maternal health and how these can be leveraged to improve health outcomes.

Consequently, traditional birth attendants are pivotal in maternal health care in developing countries like Nigeria. While they offer critical support to pregnant women, there are notable challenges associated with their practices, particularly concerning training and access to resources. The integration of TBAs into formal healthcare systems, supported by recent governmental and organizational initiatives, holds promise for enhancing maternal health outcomes. Nonetheless, further research is needed to understand the complexities of their roles and practices within specific contexts like Uzenema Uromi, ensuring that maternal health services are both culturally sensitive and effective. By doing so, we can work towards a more equitable healthcare system that respects traditional practices while promoting the health and safety of mothers and newborns alike (Doctor, 2021).

1.2       Statement of Problem

The role of traditional birth attendants (TBAs) in maternal health care is widely recognized, particularly in developing countries like Nigeria. However, significant gaps remain in the existing literature regarding the integration of TBAs into formal healthcare systems and their impact on maternal health outcomes in specific local contexts, such as Uzenema Uromi, Edo State. While previous research has acknowledged the importance of TBAs and their cultural significance, there is a lack of comprehensive studies that critically examine how their practices align or conflict with modern obstetric care (Ekanem et al., 2020).

Most studies have primarily focused on the general roles of TBAs without delving into the specific challenges they face in their communities, including issues related to training, resources, and access to healthcare facilities (Agbo, 2023). For example, while the inadequacies in training and equipment have been highlighted, there is insufficient empirical evidence detailing how these factors specifically affect maternal health outcomes in Uzenema Uromi. This gap in localized research prevents a thorough understanding of the unique socio-cultural dynamics that influence the practices of TBAs in this region.

Moreover, recent efforts by the Nigerian government to integrate TBAs into formal healthcare systems have not been evaluated in the context of Uzenema Uromi. Although national policies aim to enhance the training and resources available to TBAs, the effectiveness of these initiatives at the local level remains largely unexamined (Ebuehi & Akintujoye, 2022). Understanding how these policies are implemented and their effects on TBAs’ practices and maternal health outcomes is essential for informing future interventions.

Additionally, the perspectives of women who rely on TBAs for childbirth are often overlooked in existing research. While some studies have explored the experiences of women in urban settings, rural perspectives, particularly in places like Uzenema Uromi, are less understood (Imogie et al., 2022). This lack of representation may hinder the development of culturally sensitive and effective maternal health interventions.

Consequently, the gaps in research concerning the specific challenges faced by TBAs in Uzenema Uromi, the evaluation of government integration efforts, and the perspectives of women utilizing TBA services create a pressing need for focused studies in this area. Addressing these gaps will be vital for improving maternal health outcomes and ensuring that traditional practices are effectively integrated into modern healthcare systems.

1.3 Purpose of the Study

The primary purposes of this study are to:

1. Examine the practices of traditional birth attendants in Uzenema Uromi and their impact on maternal health outcomes.
2. Identify the factors influencing the choice of traditional birth attendance among pregnant mothers in the community.
3. Evaluate the integration of traditional birth practices with modern healthcare services and its effects on maternal and neonatal health.

1.4 Research Questions

To achieve the purposes of the study, the following research questions will guide the investigation:

1. What are the common practices of traditional birth attendants in Uzenema Uromi, and how do these practices influence maternal health outcomes?
2. What factors motivate pregnant mothers in Uzenema Uromi to seek the services of traditional birth attendants instead of formal healthcare providers?
3. How can traditional birth attendance be effectively integrated into the existing healthcare system to enhance maternal health outcomes in Uzenema Uromi?

1.5 Research Hypotheses

Based on the research questions, the following hypotheses will be tested in the study:

1. There is no significant relationship between the practices of traditional birth attendants and maternal health outcomes in Uzenema Uromi.
2. Cultural beliefs and financial constraints does not significantly influence the choice of traditional birth attendance among pregnant mothers in Uzenema Uromi.
3. The integration of traditional birth practices with formal healthcare services do not  lead to improved maternal and neonatal health outcomes.

1.6 Significance of the Study

This study aims to enhance the understanding of maternal health care practices in Nigeria, with a particular focus on the role of traditional birth attendants (TBAs). The findings will contribute significantly to the existing body of knowledge by examining the implications of TBAs on the health of pregnant women. By doing so, the study will provide valuable insights for policymakers, healthcare providers, and community leaders regarding the necessity of recognizing and addressing the contributions of TBAs within the healthcare system.

The research emphasizes the need to appreciate the unique position that TBAs hold, especially in regions where formal healthcare services are scarce. In rural areas like Uzenema Uromi, TBAs often serve as the primary caregivers for pregnant women, making their practices critical for maternal health outcomes. The insights derived from this study can facilitate a better understanding of the cultural and social dynamics that influence maternal care in these communities, thereby informing strategies to enhance healthcare delivery.

Furthermore, the study will explore avenues for integrating traditional and modern healthcare practices to ensure that pregnant women receive safe and culturally competent care. This integration is crucial in areas with limited access to formal health services, where TBAs are often the first point of contact for expectant mothers. By identifying best practices and potential challenges in this integration process, the research can contribute to developing policies that support a collaborative approach to maternal health.

The findings will also underscore the importance of training and equipping TBAs with the necessary skills and resources to improve maternal care quality. Policymakers can use this information to develop targeted training programs and resource allocation strategies that empower TBAs, enhancing their capacity to provide safe care.

Ultimately, this study seeks to bridge the gap between traditional practices and modern healthcare systems, fostering a more inclusive approach to maternal health in Nigeria. By recognizing the vital role of TBAs and integrating their services within the broader healthcare framework, the study aims to contribute to improved maternal health outcomes, particularly for women in underserved rural communities.

1.7 Scope of the Study

This study will focus on traditional birth attendance practices in Uzenema Uromi, Edo State, Nigeria. It will examine the roles, experiences, and impacts of TBAs on maternal health outcomes within the community. The study will target pregnant women who have utilized TBA services in the past year, as well as TBAs themselves.

By concentrating on this geographical area and population, the research aims to provide a detailed understanding of the implications of traditional birth attendance on maternal health, while also recognizing the cultural context that shapes these practices.

1.8 Operational Definition of Terms

1. Traditional Birth Attendant (TBA): A person who assists women during childbirth and provides postpartum care, typically without formal medical training, relying on traditional practices and knowledge.
2. Maternal Health: The health of women during pregnancy, childbirth, and the postpartum period, encompassing the physical, emotional, and social well-being of mothers.
3. Neonatal Health: The health of newborns during the first 28 days of life, which is a critical period for survival and development.
4. Cultural Practices: Behaviors, beliefs, and customs that are specific to a particular community or group, influencing healthcare choices and practices.
5. Healthcare Integration: The process of combining traditional and modern healthcare practices to create a comprehensive healthcare system that meets the needs of the community.
6. Obstetric Complications: Medical issues that arise during pregnancy and childbirth, which can adversely affect the health of the mother and newborn.
7. Postnatal Care: The care provided to mothers and newborns after childbirth, focusing on recovery and the health of both.
8. Community-Based Healthcare: A healthcare approach that emphasizes the role of community members, including TBAs, in providing accessible health services and promoting health education.