Traditional Birth Attendants (TBAs)

Controlling postpartum hemorrhage after home births in Tanzania

N Prata
G Mbaruku
M Campbell
M Potts
F Vahidnia
2005

This groundbreaking pilot study demonstrates the potential impact of misoprostol for women in rural settings. In this community-based intervention trial, misoprostol was delivered by traditional birth attendants (TBAs) for PPH treatment in rural Kigoma, Tanzania. Results show that TBAs successfully administered misoprostol. Women given misoprostol to treat PPH were far less likely to need additional intervention.

OBJECTIVES: Determine safety of household management of postpartum hemorrhage (PPH) with 1000 microg of rectal misoprostol, and assess possible reduction in referrals and...

A Textbook of Postpartum Hemorrhage: Chapter 17: Management of Postpartum Hemorrhage at the Community Level

Ndola Prata
2006

Chapter 17 in A Textbook of Postpartum Hemorrhage discussing Management of Postpartum Hemorrhage at the Community Level

The objective of this book is to bring together within a single volume the most up to date information about the epidemiology, diagnosis and management of postpartum hemorrhage. Whilst much has been published on the subject a truly comprehensive synthesis of this kind has never before been attempted. This volume sets out, therefore, to provide physicians with an overall clinical perspective that has hitherto been unavailable.

The ability to manage postpartum...

Cost-effectiveness of misoprostol to control postpartum hemorrhage in low-resource settings

S Bradley
N Prata
N Young-Lin
D Bishai
2007

Objective: To test the cost-effectiveness of training traditional birth attendants (TBAs) to recognize postpartum hemorrhage (PPH) and administer a rectal dose of misoprostol in areas with low access to modern delivery facilities.

Method: A cost-effectiveness analysis, modeling two hypothetical cohorts of 10,000 women each giving birth with TBAs: one under standard treatment (TBA referral to hospital after blood loss ≥ 500 ml), and one attended by TBAs trained to recognize PPH and to administer 1000 μg of misoprostol at blood loss ≥ 500 ml.

Result: The misoprostol strategy...

A Textbook of Postpartum Hemorrhage: Chapter 17: Management of Postpartum Hemorrhage at the Community Level

Ndola Prata
2006

Chapter 17 in A Textbook of Postpartum Hemorrhage discussing Management of Postpartum Hemorrhage at the Community Level

The objective of this book is to bring together within a single volume the most up to date information about the epidemiology, diagnosis and management of postpartum hemorrhage. Whilst much has been published on the subject a truly comprehensive synthesis of this kind has never before been attempted. This volume sets out, therefore, to provide physicians with an overall clinical perspective that has hitherto been unavailable.

The ability to manage postpartum...

Where There Are (Few) Skilled Birth Attendants

Ndola Prata
Paige Passano
Tami Rowen
Suzanne Bell
Julia Walsh
Malcolm Potts
2011

Recent efforts to reduce maternal mortality in developing countries have focused primarily on two long-term aims: training and deploying skilled birth attendants and upgrading emergency obstetric care facilities. Given the future population-level benefits, strengthening of health systems makes excellent strategic sense but it does not address the immediate safe-delivery needs of the estimated 45 million women who are likely to deliver at home, without a skilled birth attendant. There are currently 28 countries from four major regions in which fewer than half of all births are attended by...

Training traditional birth attendants to use misoprostol and an absorbent delivery mat in home births

Ndola Prata
Abdul Quaiyum
Paige Passano
Suzanne Bell
Daniel D Bohl
Shahed Hossain
Ashrafi Jahan Azm
Mohsina Begum
2012

A 50-fold disparity in maternal mortality exists between high- and low-income countries, and in most contexts, the single most common cause of maternal death is postpartum hemorrhage (PPH). In Bangladesh, as in many other low-income countries, the majority of deliveries are conducted at home by traditional birth attendants (TBAs) or family members. In the absence of skilled birth attendants, training TBAs in the use of misoprostol and an absorbent delivery mat to measure postpartum blood loss may strengthen the ability of TBAs to manage PPH. These complementary interventions were tested in...

Evaluation of a traditional birth attendant training programme in Bangladesh

Ndola Prata
Paige Passano
Tami Rowen
2011

Background and context: the 1997 Safe Motherhood Initiative effectively eliminated support for training traditional birth attendants (TBAs) in safe childbirth. Despite this, TBAs are still active in many countries such as Bangladesh, where 88% of deliveries occur at home. Renewed interest in community-based approaches and the urgent need to improve birth care has necessitated a re-examination of how provider training should be conducted and evaluated.

Objective: to demonstrate how a simple evaluation tool can provide a quantitative measure of knowledge...