Community perceptions towards the new role of traditional birth attendants as birth companions and nutrition advocates in Kakamega County, Kenya

• Published in: Maternal and child nutrition Vol. 14; no. S1
• Main Authors: Anono, Esther L., Ochola, Sophie, Wawire, Salome, Ogada, Irene, Ndedda, Crispin, Kung'u, Jacqueline K.
• Format: Journal Article
• Language: English
• Published: England John Wiley and Sons Inc 01.02.2018
• Subjects: Attitude to Health; birth companion; Community Health Workers - education; Delivery, Obstetric - methods; Female; Health Facilities; Humans; Infant; Infant Mortality; Infant, Newborn; Kenya; Lactation; Maternal Mortality; Maternal Nutritional Physiological Phenomena; nutrition; nutrition advocate; Nutrition Therapy - methods; Patient Education as Topic; Perception; Pregnancy; pregnant women; skilled birth atttendant; Supplement; Surveys and Questionnaires; traditional birth attendant; Kenya; skilled birth atttendant; traditional birth attendant; nutrition; nutrition advocate; pregnant women; birth companion
• ISSN: 1740-8695; 1740-8709
• DOI: 10.1111/mcn.12578

Delivery with skilled birth attendants is important for reducing maternal mortality in developing countries. However, traditional birth attendants (TBAs) are abundant in such settings, managing deliveries without the skills and resources necessary to prevent mortality in this situations. Interventions that have been proposed to mitigate the situation include redefining the role of TBAs to nutrition advocates and birth companions for pregnant women to health facilities. We thus explored community perceptions on these new roles of TBAs, as birth companions and nutrition advocates, and their influence on health facility deliveries in Kakamega County, Kenya. Qualitative data was collected through key informant interviews with health workers and focus group discussions with lactating mothers, pregnant women, husbands, community leaders, community health volunteers, and TBA. Content analysis was conducted; data was organized into subthemes and conclusions made from each subtheme using Atlas.ti software. TBAs adopted their birth companion role as the majority offered companionship to mothers delivering at health facilities. Mothers were happy with this role as TBAs continued providing companionship even after delivery. The community members were happy with the new role of TBAs and reported increased deliveries at the health facilities. In contrast, TBAs did not adopt the nutrition advocacy role sufficiently. We found that redefining the role of the TBAs into birth companions to support facility‐based delivery is thus feasible and acceptable. Nutrition advocacy by the TBAs should be strengthened to maximize on the opportunity provided by the close association between TBAs and mothers and the community.