Absztrakt
Background: Traditional birth attendants (TBAs) represent an important component of the healthcare
system and are present at 50% of deliveries in developing countries. Despite the training given to TBAs by significant
organisations on timely referrals, maternal deaths attributed to delay in referrals persists. The aim of this study was to assess the
reported referral practices of trained TBAs in Ibadan.
Methods: A cross-sectional study was conducted among trained TBAs in Ibadan North and Lagelu Local
Government Areas of Ibadan, Oyo state utilising mixed methods. A total of 114 trained TBAs were
randomly selected and completed a questionnaire. Eight TBA leaders were interviewed using a key
informant interview guide. The quantitative data was analysed using the Statistical package for social
sciences (SPSS) version 22 and t-test at α= 0.05.The qualitative data was analysed with NVivo version
12.
Results: Findings revealed that 61.4% of the TBAs had good referral practices. The leading perceived
factors influencing the referral practices of the TBAs was rejection of referral by the pregnant women,
cost and attitude of health care workers. A strong theme that emerged during the KIIs indicated that
referral decisions were made by the TBAs although that did not guarantee compliance. There was no
significant difference in the referral practice of TBAs located at semi urban or urban area (t=0.429,
p=0.669).
Conclusion: There is need to subsidise cost of health care for pregnant women, improve attitude of health
care workers and to target the pregnant women when developing policies on referral.
Keywords: Traditional birth attendants, Health Personnel, Referral, Pregnant women, Delivery, Health
Facilities
Résumé
Contexte : Les accoucheuses traditionnelles représentent un élément important du système de santé et sont
présentes dans 50% des accouchements dans les pays en développement. En dépit de la formation donnée
aux accoucheuses traditionnelles par des organisations importantes sur la référence en temps voulu, les
décès maternels attribués à un retard de référence persistent. Le but de cette étude était d’évaluer les
pratiques de référence signalés des accoucheuses traditionnelles formées à Ibadan.
Méthodes : Une étude transversale a été menée parmi les accoucheuses traditionnelles formées dans les
communes d’Ibadan North et de Lagelu à Ibadan, État d’Oyo, à l’aide de méthodes mixtes. Un total de
114 accoucheuses traditionnelles formées a été sélectionné au hasard et elles ont rempli un
questionnaire. Huit dirigeantes d’accoucheuses traditionnelles ont été interrogés à l’aide d’un guide
d’entrevue avec informateur clé (KII). Les données quantitatives ont été analysées à l’aide du logiciel
SPSS (Statistical package for social sciences) version 22 et le test t à α = 0,05. Les données qualitatives
ont été analysées à l’aide de NVivo version 12.
Résultats : Les résultats ont révélé que 61,4% des accoucheuses traditionnelles avaient de bonnes
pratiques en matière de référence. Les principaux facteurs qui ont influencé les pratiques de référence des
accoucheuses traditionnelles ont été le refus de la référence par les femmes enceintes, le coût et l’attitude
des agents de santé. Un thème fort qui a émergé au cours des KII indiquait que les décisions de référence
étaient prises par les accoucheuses traditionnelles, bien que cela ne garantisse pas la conformité. Il n’y
avait pas de différence significative dans la pratique de référence des accoucheuses traditionnelles situées
dans des communes semi-urbaines ou urbaines (t = 0,429, p = 0,669).
Conclusion : Il est nécessaire de subventionner le coût des soins de santé pour les femmes enceintes,
d’améliorer l’attitude des agents de santé et de cibler les femmes enceintes lors de l’élaboration de
politiques sur la référence.
Mots-clés : Accoucheuses traditionnelles, personnel de santé, référence, femmes enceintes, accouchement, établissements de santé
Correspondence: Bukola D. Oladimeji, Department of Nursing, National Hospital, Abuja, Nigeria. E-mail:
bshodimeji@gmail.com
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