The role of traditional birth attendants in reducing maternal mortality rates in Hombolo ward, Dodoma

Maternal mortality rates are still high in most of the developing countries. This is influenced by several factors; one of them being lack or inaccessibility of health facilities in most rural areas. This is a gap filled by Traditional Birth Attendants (TBAs) who are always accessible by rural people, but unfortunately these TBAs lack modern ways of taking care of mothers during pre-natal,intra-natal and post-natal periods. This study aims to assess the role of TBAs in reducing Maternal Mortality Rates (MMR) in Hombolo Ward. This study is guided by three objectives, which are; to examine activities performed by TBAs in reducing MMR in Hombolo Ward, to examine efficiency of TBAs’ knowledge and skills during pre-natal, intra-natal and post-natal periods that can reduce MMR in the study area as to evaluate means of integrating best practices of TBAs into modern ways of health services in order to develop the best ways for harmonizing the two. Both qualitative and quantitative research methods were employed to ensure methodological triangulation so as to maximize the quality of the output. This study involved 145 women who have been assisted by TBAs to deliver in the past two years prior to the study. These women provided information and their opinions regarding this study. The finding revealed that TBAs perform activities to mothers during pregnancy, delivery and post delivery times. These activities include abdominal message, provision of herbs, advice on eating behaviors, assisting mothers to deliver, umbilical cord cutting, and encouraging breastfeeding and immunization. However, when complication arises while performing these activities to mothers, TBAs refer only 67% of the respective mothers to a health facility. In contrast the Ministry of Health, Community Development, Elderly and Children advices 100% referral of women who experience complications during pregnancy or delivery to the health facilities. But the challenge remains that some health facilities are inaccessible due to poor infrastructure and long distances from interior villages, The study also revealed that there were inadequate formal trainings to TBAs in Hombolo Ward. This means TBAs conduct their activities mostly relying on the traditional knowledge and experience. The findings also revealed that there is a linkage between TBAs services and modern maternal services. In order to reduce MMR, there is a need to further strengthen the relationship of the two sectors through training. The study concluded that TBAs are essential in saving lives of maternal mothers and infants, especially in rural areas where accessibility to health facilities is questionable. Low fatalities among infants and mothers who deliver at TBAs tend to reduce fear regarding the complications that mothers can face during pregnancy or delivery, hence increasing TBAs preference. The study recommended that maternal health education should be provide to mothers and community at large so as to provide knowledge regarding obstetric complications in order to encourage health facility delivery. It is also recommended that TBAs should be trained so as to improve their performance and responsibilities and help them identify their boundaries so as to reduce maternal mortality in Tanzania.