Skip to main content
Top
Published in: BMC Public Health 1/2010

Open Access 01-12-2010 | Research article

Traditional birth attendants lack basic information on HIV and safe delivery practices in rural Mysore, India

Authors: Purnima Madhivanan, Bhavana N Kumar, Paul Adamson, Karl Krupp

Published in: BMC Public Health | Issue 1/2010

Login to get access

Abstract

Background

There is little research on HIV awareness and practices of traditional birth attendants (TBA) in India. This study investigated knowledge and attitudes among rural TBA in Karnataka as part of a project examining how traditional birth attendants could be integrated into prevention-of-mother-to-child transmission of HIV (PMTCT) programs in India.

Methods

A cross-sectional survey was conducted between March 2008 and January 2009 among TBA in 144 villages in Mysore Taluk, Karnataka. Following informed consent, TBA underwent an interviewer-administered questionnaire in the local language of Kannada on practices and knowledge around birthing and HIV/PMTCT.

Results

Of the 417 TBA surveyed, the median age was 52 years and 96% were Hindus. A majority (324, 77.7%) had no formal schooling, 88 (21.1%) had up to 7 years and 5 (1%) had more than 7 yrs of education. Only 51 of the 417 TBA (12%) reported hearing about HIV/AIDS. Of those who had heard about HIV/AIDS, only 36 (72%) correctly reported that the virus could be spread from mother to child; 37 (74%) identified unprotected sex as a mode of transmission; and 26 (51%) correctly said healthy looking people could spread HIV. Just 22 (44%) knew that infected mothers could lower the risk of transmitting the virus to their infants. An overwhelming majority of TBA (401, 96.2%) did not provide antenatal care to their clients. Over half (254, 61%) said they would refer the woman to a hospital if she bled before delivery, and only 53 (13%) felt referral was necessary if excessive bleeding occurred after birth.

Conclusions

Traditional birth attendants will continue to play an important role in maternal child health in India for the foreseeable future. This study demonstrates that a majority of TBA lack basic information about HIV/AIDS and safe delivery practices. Given the ongoing shortage of skilled birth attendance in rural areas, more studies are needed to examine whether TBA should be trained and integrated into PMTCT and maternal child health programs in India.
Literature
1.
go back to reference UNICEF: State of the World's Children 2009: Maternal and Newborn Health. New York. 2009, --- Either ISSN or Journal title must be supplied.. UNICEF: State of the World's Children 2009: Maternal and Newborn Health. New York. 2009, --- Either ISSN or Journal title must be supplied..
3.
go back to reference McClure EM, Wright LL, Goldenberg RL, Goudar SS, Parida SN, Jehan I, Tshefu A, Chomba E, Althabe F, Garces A, et al: The global network: a prospective study of stillbirths in developing countries. Am J Obstet Gynecol. 2007, 197 (3): 247-10.1016/j.ajog.2007.07.004. e241-245CrossRefPubMedPubMedCentral McClure EM, Wright LL, Goldenberg RL, Goudar SS, Parida SN, Jehan I, Tshefu A, Chomba E, Althabe F, Garces A, et al: The global network: a prospective study of stillbirths in developing countries. Am J Obstet Gynecol. 2007, 197 (3): 247-10.1016/j.ajog.2007.07.004. e241-245CrossRefPubMedPubMedCentral
4.
go back to reference Mavalankar D, Vora K, Prakasamma M: Achieving Millennium Development Goal 5: is India serious?. Bulletin of the World Health Organization. 2008, 86 (4): 243-243A. 10.2471/BLT.07.048454.CrossRefPubMedPubMedCentral Mavalankar D, Vora K, Prakasamma M: Achieving Millennium Development Goal 5: is India serious?. Bulletin of the World Health Organization. 2008, 86 (4): 243-243A. 10.2471/BLT.07.048454.CrossRefPubMedPubMedCentral
5.
go back to reference WHO: PMTCT strategic vision 2010-2015: preventing mother-to-child transmission of HIV to reach the UNGASS and Millennium Development Goals. 2010, Geneva: World Health Organization WHO: PMTCT strategic vision 2010-2015: preventing mother-to-child transmission of HIV to reach the UNGASS and Millennium Development Goals. 2010, Geneva: World Health Organization
6.
go back to reference Greenwood AM, Bradley AK, Byass P, Greenwood BM, Snow RW, Bennett S, Hatib-N'Jie AB: Evaluation of a primary health care programme in The Gambia. I. The impact of trained traditional birth attendants on the outcome of pregnancy. The Journal of tropical medicine and hygiene. 1990, 93 (1): 58-66.PubMed Greenwood AM, Bradley AK, Byass P, Greenwood BM, Snow RW, Bennett S, Hatib-N'Jie AB: Evaluation of a primary health care programme in The Gambia. I. The impact of trained traditional birth attendants on the outcome of pregnancy. The Journal of tropical medicine and hygiene. 1990, 93 (1): 58-66.PubMed
7.
go back to reference Jokhio AH, Winter HR, Cheng KK: An intervention involving traditional birth attendants and perinatal and maternal mortality in Pakistan. The New England journal of medicine. 2005, 352 (20): 2091-2099. 10.1056/NEJMsa042830.CrossRefPubMed Jokhio AH, Winter HR, Cheng KK: An intervention involving traditional birth attendants and perinatal and maternal mortality in Pakistan. The New England journal of medicine. 2005, 352 (20): 2091-2099. 10.1056/NEJMsa042830.CrossRefPubMed
8.
go back to reference Perez F, Aung KD, Ndoro T, Engelsmann B, Dabis F: Participation of traditional birth attendants in prevention of mother-to-child transmission of HIV services in two rural districts in Zimbabwe: a feasibility study. BMC public health. 2008, 8: 401-10.1186/1471-2458-8-401.CrossRefPubMedPubMedCentral Perez F, Aung KD, Ndoro T, Engelsmann B, Dabis F: Participation of traditional birth attendants in prevention of mother-to-child transmission of HIV services in two rural districts in Zimbabwe: a feasibility study. BMC public health. 2008, 8: 401-10.1186/1471-2458-8-401.CrossRefPubMedPubMedCentral
9.
go back to reference Msaky H, Kironde S, Shuma J, Nzima M, Mlay V, Reeler A: Scaling the frontier: traditional birth attendant involvement in PMTCT service delivery in Hai and Kilombero districts of Tanzania. abstract no.: ThPeE8084. International Conference on AIDS 2004; Bangkok, Thailand. 2004 Msaky H, Kironde S, Shuma J, Nzima M, Mlay V, Reeler A: Scaling the frontier: traditional birth attendant involvement in PMTCT service delivery in Hai and Kilombero districts of Tanzania. abstract no.: ThPeE8084. International Conference on AIDS 2004; Bangkok, Thailand. 2004
10.
go back to reference Mulder S: Midwifery in rural India: a study of traditional birth attendants in Tamil Nadu, India. Aust Coll Midwives Inc J. 1995, 8 (1): 24-30. 10.1016/S1031-170X(05)80009-1.CrossRefPubMed Mulder S: Midwifery in rural India: a study of traditional birth attendants in Tamil Nadu, India. Aust Coll Midwives Inc J. 1995, 8 (1): 24-30. 10.1016/S1031-170X(05)80009-1.CrossRefPubMed
11.
go back to reference Trollope-Kumar K: The Traditional Birth Attendant in Garhwal, India: Towards a Culturally Relevant Training Program. Canadian Journal of Midwifery Research and Practice. 2002 Trollope-Kumar K: The Traditional Birth Attendant in Garhwal, India: Towards a Culturally Relevant Training Program. Canadian Journal of Midwifery Research and Practice. 2002
16.
go back to reference Kausar R: Maternal Mortality in India - Magnitude, Causes and Concerns. Indian Journal for the Practising Doctor. 2005, 2 (2): Kausar R: Maternal Mortality in India - Magnitude, Causes and Concerns. Indian Journal for the Practising Doctor. 2005, 2 (2):
18.
go back to reference Wanyu B, Diom E, Mitchell P, Tih PM, Meyer DJ: Birth attendants trained in "Prevention of Mother-To-Child HIV Transmission" provide care in rural Cameroon, Africa. Journal of midwifery & women's health. 2007, 52 (4): 334-341.CrossRef Wanyu B, Diom E, Mitchell P, Tih PM, Meyer DJ: Birth attendants trained in "Prevention of Mother-To-Child HIV Transmission" provide care in rural Cameroon, Africa. Journal of midwifery & women's health. 2007, 52 (4): 334-341.CrossRef
19.
go back to reference Satishchandra DM, Naik VA, Wantamutte AS, Mallapur MD: Impact of training of traditional birth attendants on the newborn care. Indian J Pediatr. 2009, 76 (1): 33-36. 10.1007/s12098-008-0229-9.CrossRefPubMed Satishchandra DM, Naik VA, Wantamutte AS, Mallapur MD: Impact of training of traditional birth attendants on the newborn care. Indian J Pediatr. 2009, 76 (1): 33-36. 10.1007/s12098-008-0229-9.CrossRefPubMed
20.
go back to reference Mathur HN, Sharma PN, Jain TP: The impact of training traditional birth attendants on the utilisation of maternal health services. J Epidemiol Community Health. 1979, 33 (2): 142-144. 10.1136/jech.33.2.142.CrossRefPubMedPubMedCentral Mathur HN, Sharma PN, Jain TP: The impact of training traditional birth attendants on the utilisation of maternal health services. J Epidemiol Community Health. 1979, 33 (2): 142-144. 10.1136/jech.33.2.142.CrossRefPubMedPubMedCentral
21.
go back to reference Bang AT, Bang RA, Baitule SB, Reddy MH, Deshmukh MD: Effect of home-based neonatal care and management of sepsis on neonatal mortality: field trial in rural India. Lancet. 1999, 354 (9194): 1955-1961. 10.1016/S0140-6736(99)03046-9.CrossRefPubMed Bang AT, Bang RA, Baitule SB, Reddy MH, Deshmukh MD: Effect of home-based neonatal care and management of sepsis on neonatal mortality: field trial in rural India. Lancet. 1999, 354 (9194): 1955-1961. 10.1016/S0140-6736(99)03046-9.CrossRefPubMed
Metadata
Title
Traditional birth attendants lack basic information on HIV and safe delivery practices in rural Mysore, India
Authors
Purnima Madhivanan
Bhavana N Kumar
Paul Adamson
Karl Krupp
Publication date
01-12-2010
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2010
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/1471-2458-10-570

Other articles of this Issue 1/2010

BMC Public Health 1/2010 Go to the issue