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Traditional Birth Attendants and Policy Ambivalence in Zimbabwe

DOI: 10.1155/2014/750240

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Abstract:

This paper analyses the importance of the services rendered by traditional birth attendants (TBAs) to pregnant women in Zimbabwe. It argues that, though an integral part of the health system, the ambivalence in terms of policy on the part of the government leaves them in a predicament. Sociocultural values as well as tradition imbue TBAs power and authority to manage pregnancies and assist in child deliveries. On the other hand, government policies expounded through the Ministry of Health (MoH) programs and policies appear to be relegating them to the fringes of healthcare provision. However, in a country with a failing health system characterized by mass exodus of qualified personnel, availability of drugs, and understaffing of healthcare centres, among others, TBAs remain the lifeline for many women in the country. Instead of sidelining them in healthcare interventions, I argue that their integration, however, problematic and often noted to be with disastrous consequences for traditional medicine, presents the sole viable solution towards achieving MDGs 4 and 5. The government and MoH should capitalize on the availability of and standing working relations of TBAs with the grassroots for better/positive maternal health outcomes. In a country reeling with high maternal deaths, TBAs’ status and position in society make them the best intervention tools. 1. Introduction African traditional healthcare is grounded in thousands of years of knowledge and has sustained life, on its own or in concert with Western medicine. A traditional birth attendant is defined as a person who assists the mother during childbirth and initially acquired her skills by delivering babies herself or through apprenticeship to other TBAs [1]. According to Kruske and Barclay [2] approximately half of all births in developing countries are attended by traditional birth attendants (TBAs) and as many as 95% of women are attended by TBAs. It is against this background that I argue that rather than continuing to develop interventions grounded in a Western medicine world view of healthcare there is need to develop programs that are inclusive of healers who reflect the sociocultural beliefs of the community. There is also need to understand the local context and value traditional knowledge systems. Such calls are themselves not a new phenomenon; for example, Jordan [3] called for the replacement of top-down, culturally inappropriate, biomedically oriented models with those of mutual accommodation. This is what Graham [4] calls the “partnership paradigm,” that is, the mutual cooperation of

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