TBA programmes: a comprehensive literature review

Abstract

Of the 500,000 women who die every year due to pregnancy related causes 99% live in developing countries. Most deliveries in developing countries are non-institutional and take place at home by traditional birth attendants (TBA). With the expectation cf decreasing maternal mortality TBA training programmes were started in many developing countries. The objectives of this literature review was to identify the issues in TBA programmes, and also identify the gaps in research conducted so far. This review encompasses three perspectives: global, Government of Bangladesh, and non-government organizations specially BRAC. The review identified the following programme relevant issues: bin:h attendants and practices; evolution of TBA programmes; programme objectives; structure of TBA programmes (type of service, service providers and recipients); service giving process: training (target population, trainee selection criteria, course schedule and content, incentives for this work, TBA perceptions about birth process, trainers, monitoring and supervision of TBAs); outcome of TBA training programmes (impact on maternal and infant mortality and morbidity indicators, client satisfaction, change in KAP of trained TBAs (TTBA), evaluation of TTBA's performance, utilization of TTBAs, TTBAs' linkage with other health workers; and cost effectiveness of TBA programmes.