Chinyere Joy Nnamchi
St. Theresa Hospital and Maternity, Nigeria
Posters & Accepted Abstracts: Adv Practice Nurs
Historically, traditional birth attendants have provided life-line support for many women in need of maternity care services in the rural areas of most developing countries such as Nigeria. Owing to economic hardships and increasing shortage of formally trained midwives, many pregnant women in rural areas seek the services of traditional birth attendants. Using qualitative research, we investigated the care practices in eight rural maternity care settings in Enugu, Nigeria. We carried out observational studies of the care procedures in the rural maternity care homes and conducted eight focus group studies and 19 one-on-one interviews involving 27 traditional birth attendants and 154 women who have used the services of traditional birth attendants during their prenatal, birthing, and postpartum periods. Primary assessment measures included evaluations of the structure and practices of maternity care adopted by traditional birth attendants. Our study suggests a lack of conformity between the structure, process and practices in rural maternity care homes and standards of care practice expected in modern obstetric nursing, including lack of adherence to basic hygiene standards and a tendency to administer parenteral injections that often lead to complications. However, traditional birth attendants fill a void created by the severe lack of midwives in many parts of Africa; in addition, they are mostly located in underserved rural communities where they are often the best care services available for pregnant women. Based on our findings, this paper proposes the adoption of an integrated maternal care model that seeks not only to provide regular trainings for traditional birth attendants, but also integrates them into the Nigeria healthcare system for rural communities. Drawing upon extant literature in contemporary maternity care and obstetric nursing in Africa and other less-developed parts of the world. We argue that such an integrated maternal care model, in order to be successful, will involve skill-based training for traditional birth attendants as well as incorporate mobile technologybased messaging services that support collaborative working and referrals between traditional birth attendants and trained midwives and doctors for more effective care service outcome.
Chinyere Joy Nnamchi is a Registered Nurse with the Nursing and Midwifery Council of Nigeria. She currently works as a Staff Nurse at St. Theresa’s Hospital and Maternity Care, Abakpa Nike, Enugu, Nigeria. She holds a Bachelor’s degree in Nursing from Ebonyi State University and is working toward her Master’s degree in Maternal Health and Obstetric Nursing. Her research interests include women’s health, prenatal care, and rural maternity care services.