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Traditional Birth attendant in rural Haiti Agathe Jn Baptiste, MD

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Traditional Birth attendant in rural Haiti Agathe Jn Baptiste, MD. Indicators. 8.5 million people; 65% in extreme poverty Life expectancy at birth: 52 25 doctors and 11 nurses/100,000 people Under-5 mortality rate, 2005 : 120

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Presentation Transcript
indicators
Indicators
  • 8.5 million people; 65% in extreme poverty
  • Life expectancy at birth: 52
  • 25 doctors and 11 nurses/100,000 people
  • Under-5 mortality rate, 2005 : 120
  • Infant mortality rate (under 1), 2005 : 84
  • Annual no. of births (thousands), 2005: 255
  • Skilled attendant at delivery (%), 1997-2005: 24
  • Maternal mortality ratio† , 1990-2005, 520
  • Maternal mortality ratio† , 2000, Lifetime risk of maternal death. 1 in: 29
who and how
Who and How
  • Assists the mother during childbirth
  • Have acquired skills by delivering babies herself, or through apprenticeship of other TBAs.
  • Self attendance of birth
  • Have cut the umbilical cord once
more than that
More than that
  • Like in other developing countries they are primary pregnancy and childbirth care provider
  • Traditional healers
  • Herbalists
role of the tba and why home deliveries preferred
Role of the TBA and why home deliveries preferred
  • Emotional support
  • Traditional delivery care
  • Post partum care
  • Health advice and education
  • Long distance from health facilities
role cont
Baby care

Umbilical cord

Bath (Taboo)

Lock (special beverage given to the baby facilitating the first feces or meconium)

Mother

Hip bath (Herbs)

Medicines

Corporal massage

Nutrition

Role (cont.)
lack of referral
Lack of referral

TBA

  • Seen as incompetent
  • Not been paid

Pregnant Women

  • Fear
  • Pregnant women usually praise TBA to do everything they can to avoid Hospital (expenses, travel, clothes, food)
  • Considered mistreated by Health professional
  • Episiotomy (considered not normal)
  • Would not be able to get the placenta
the major emphasis of training
The major emphasis of training
  • Increased safety in the TBAs practice, such as cleanliness, especially washing of the hands and clean or sterile cord-cutting procedures
  • Non-interference during labor
  • Identification and referrals of mother at risk
  • Doing away with traditional harmful practices and leaving alone or supporting those that contribute to psychosocial support
other topics
Human anatomy focusing upon the reproductive system reproduction

And pregnancy from fecundation to delivery

Family planning

Nutrition

Breastfeeding

Other topics
some problems to be addressed
Some problems to be addressed
  • Lack of an organized system to supervise trained TBAs
  • Provide continued training for them
  • Availability of basic supplies, such as cord care kits
  • Bridge between the community and the formal health system
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