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BMC Pregnancy and Childbirth
Published in: BMC Pregnancy and Childbirth 1/2016

Open Access 01-12-2016 | Research article

Towards universal access to skilled birth attendance: the process of transforming the role of traditional birth attendants in Rural China

Authors: Hong Jiang, Xu Qian, Lili Chen, Jian Li, Erin Escobar, Mary Story, Shenglan Tang

Published in: BMC Pregnancy and Childbirth | Issue 1/2016

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Abstract

Background

Institution-based childbirth, with the ultimate goal of universal access to skilled birth attendance (SBA), has been selected as a key strategy to reduce the maternal mortality rate in many developing countries. However, the question of how to engage traditional birth attendants (TBAs) in the advocacy campaign for SBA poses a number of challenges. This paper aims to demonstrate how TBAs in rural regions of China have been integrated into the health system under a policy of institutional delivery.

Methods

Research was conducted through literature and document reviews and individual in-depth interviews with stakeholders of the safe motherhood program in rural Guangxi Zhuang Autonomous Region, China. A total of 33 individual interviews were conducted with regional and local politicians, policy makers, health managers, health providers, civil society members, village cadres for women affairs, former TBAs, village maternal health workers, mothers and their mother-in-laws.

Results

Since 1998, TBA’s traditional role of providing in-home care during childbirth has been restructured and their social role has been strengthened in rural Guangxi. TBAs were redesigned to function as the linkage between women and the health system. A new policy in 1999 shifted the role of TBAs to village maternal health workers whose responsibilities were mainly to promote perinatal care and institution-based delivery of pregnant women. This successful transformation involved engaging with government and other actors, training TBAs for their new role, and providing incentives and sanctions for human resources management.

Conclusions

The China experience of transforming the role of TBAs in Guangxi rural area is an example of successfully engaging TBAs in promoting institution-based childbirth.
Literature
1.
2.
3.
4.
5.
6.
7.
WHO. Traditional birth attendants-a joint WHO/UNFPA/UNICEF statement. Geneva: World Health Organization; 1992.
8.
Minitry of Health, UNICEF China, National Working Committee of Women and Children. China Safe Motherhood in China: Progress and prospects of UNICEF supported project. 2003.
9.
Tarnpol PW. Maternal survival: improving access to skilled care. A behavior change approach. The Change Project. Washington, DC: Academy for Educational Development; 2005. 9 p.
10.
Kruske S, Barclay L. Effect of shifting policies on traditional birth attendant training. J Midwifery Women’s Health. 2004;49(4):306–11.CrossRef
11.
WHO. Making Pregnancy Safer: The Critical Role of the Skilled Attendant: A Joint Statement by WHO, ICM and FIGO. Geneva: World Health Organization; 2004.
12.
Ministry of Foreign Affairs, People’s Republic of China. Report on China’s implementation of the Millennium Development Goals (2000-2015). 2015
13.
14.
Guangxi Working Committee on Children and Women, Guangxi Health Bureau. Plan of Action for the Safe Mother Project of Guangxi. (in Chinese). 1999
15.
HEPVIC Consortium. Country reports on health policy-making, its determinants and their inter-relationships. Leeds: Nuffield Centre for International Health and Development; 2009.
16.
Green J, Thorogood N. Qualitative Methods for Health Research. London: Sage Publication Ltd; 2009.
17.
Li J. Study on Evaluation for Safe Motherhood Policy of Guangxi (Dissertation). Shanghai, China: Fudan University; 2008 (in Chinese).
18.
Lin DX. The practice and consideration of the transforming roles of family delivery attendants. Chin J Maternal Child Care. 2001;16(1):17–8 (in Chinese).
19.
Jiang H, Chen LL, Li J, Yang XG, Qian X. The qualitative analysis on the policy making and development of the stretcher action of safe motherhood program in Guangxi Zhuang Autonomous Region. Chin J Maternal Child Health. 2011;4(2):3–8 (in Chinese).
20.
Guangxi health information network. The speech of director of Guangxi health bureau on the meeting of maternal and children health of Guangxi, March 27, 2007. http://​www.​gxhfpc.​gov.​cn/​. (accessed Feb 10, 2009) (in Chinese)
21.
WHO. The World Health Report 2005: Make every mother and child count. Geneva: World Health Organization; 2005.
22.
Haththotuwa H, Senanayake L, Senarath U, Attygalle D. Models of Care that have reduced Maternal Mortality and morbidity in Sri Lanka. Int J Gynecol Obstet. 2012;119:S45–9.CrossRef
23.
Onikepe O, Claire G, Simon L, Neil P. Stakeholder views on the incorporation of traditional birth attendants into the formal health systems of low-and middle-income countries: a qualitative analysis of the HIFA2015 and CHILD2015 email discussion forums. BMC Pregnancy Childbirth. 2014;14:118. doi:10.​1186/​1471-2393-14-118.CrossRef
24.
Ana J. Are traditional birth attendants good for improving maternal and perinatal health?Yes. BMJ. 2011;342:d3310.CrossRefPubMed
25.
Harrison KA. Are traditional birth attendants good for improving maternal and perinatal health? No. BMJ. 2011;342:d3308.CrossRefPubMed
26.
27.
Titaley CR, Hunter CL, Dibley MJ, Heywood P. Why do some women still prefer traditional birth attendants and home delivery? A qualitative study on delivery care services in West Java Province, Indonesia. BMC Pregnancy Childbirth. 2010;10:43.CrossRefPubMedPubMedCentral
28.
Li J, Chen LL, Chen SZ, Cen YM, Zhao NQ, Qian X. Study on the status of institutional delivery and its determinants in rural Guangxi autonomous region. Chinese J Epidemiology. 2008;29(3):224–9 (in Chinese).
Metadata
Title
Towards universal access to skilled birth attendance: the process of transforming the role of traditional birth attendants in Rural China
Authors
Hong Jiang
Xu Qian
Lili Chen
Jian Li
Erin Escobar
Mary Story
Shenglan Tang
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Pregnancy and Childbirth / Issue 1/2016
Electronic ISSN: 1471-2393
DOI
https://doi.org/10.1186/s12884-016-0854-7

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