It is the right of every woman to choose her health care provider and that of her baby. On the other hand, it is also the duty of government to ensure that all health care providers meets required standard for users.
Traditional birth services have been an ancient practice especially in Africa. Even with modern facilities in place, women still visit homes of TBAs to access their services especially ANC and delivery. Associated reasons are the cost of delivery which is perceived to be affordable and traditional believes of “that is where our fore fathers were delivered”. Stopping women from using the TBAs services has become inevitable and so government should strengthening existing TBAs to ensure that practice is of standard to avoid maternal and child mortality.
With support from DFID through its Partnership for Transforming Health System Programme, CSOs and Government have been supported to work with community groups and Ward Health Committees (WHC) to ensure that TBAs work within their limit and referral emergency cases to the nearest health facility to avoid death of mother and child in the community.
Lagos State government has ensured that registered TBAs benefit from this one year pilot programme in communities within selected LGAs. Registered TBAs has received series of trainings from government and private institutions on best practices of MCH. Also, a cordial working relationship with common understanding of save mother and child has been established between TBAs and government health workers. At emergency, TBAs can call on the nearest facility to pick patient with their ambulance or arranged vehicle. TBAs are not certified to give injection or prescribe drugs to patient women. They are not expected to take delivery of first time pregnancy, women who have undergoes an operation before or woman with high blood pressure. They are expected to know the danger signs of pregnancy and refer cases immediately without doing try and error with the life of the mother and child.
The Ward Health Committee and community groups trained are to generate feedback from women who use the services to ensure effective service delivery and performance of the TBA. Community members should get involved in facility decision making and ensure accessible of women to the facility. They are not to act as an authority to TBA facility owners but as a supporting group for the interest of women using the facility.
Many of the TBAs also work with the nearest PHCs to carry out their immunization due to distance of the PHC to the community. Immunization service is carried out by Egan PHC at God is Wise Community Tradition Birth Center due to the distance from the community to the PHC. Nurses at the PHCs come with necessary vaccines for children on immunization days.
The one year pilot project is to strengthening health system on maternal and child health. Community groups and WHC are to work together to support the initiative with mentoring support also from the CSOs.