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Traditional Birth attendant in rural Haiti Agathe Jn Baptiste, MD PowerPoint PPT Presentation


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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Traditional Birth attendant in rural Haiti Agathe Jn Baptiste, MD

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Traditional Birth attendant in rural Haiti

Agathe Jn Baptiste, MD


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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


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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


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More than that

  • Like in other developing countries they are primary pregnancy and childbirth care provider

  • Traditional healers

  • Herbalists


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Most traditional midwives live in rural and often isolated communities

Illiterate

Women / Men

Mostly Elders

Characteristics


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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


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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.)


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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


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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


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Human anatomy focusing upon the reproductive system reproduction

And pregnancy from fecundation to delivery

Family planning

Nutrition

Breastfeeding

Other topics


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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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