Integration: The systematic collaboration between traditional and formal healthcare systems
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Background of the Study
Traditional birth attendants (TBAs) have long played a pivotal role in maternal healthcare, especially in regions with limited access to formal healthcare services. In Borno State, where geographical and infrastructural challenges hinder access to modern obstetric care, TBAs often serve as the primary providers of prenatal, delivery, and postnatal services. TBAs are deeply embedded in the local culture and are trusted figures within communities. However, their practices vary widely, and there is ongoing debate regarding the safety and effectiveness of TBA-assisted deliveries. While TBAs can offer timely and culturally sensitive care, inadequate training and a lack of integration with formal health systems may lead to increased risks for complications during childbirth. This study will investigate the role of TBAs in maternal healthcare delivery in Borno State by assessing their training, practices, and collaboration with formal healthcare providers. The aim is to determine the extent to which TBAs contribute to maternal health outcomes and to identify strategies to enhance their effectiveness through integration and capacity building.
Statement of the Problem
In Borno State, traditional birth attendants remain a critical source of maternal healthcare due to limited access to formal medical facilities. However, the reliance on TBAs is associated with variable outcomes, as many TBAs lack standardized training and do not follow evidence-based practices. This situation has contributed to preventable maternal and neonatal complications, including infections, prolonged labor, and hemorrhage. Additionally, the lack of a formal referral system between TBAs and modern healthcare facilities often delays critical interventions during emergencies. Despite their integral role in the community, there is a dearth of data on the quality and safety of maternal care provided by TBAs. This study seeks to address this gap by systematically examining the practices of TBAs in Borno State, evaluating their impact on maternal health, and exploring opportunities for enhanced collaboration with formal health systems to improve outcomes.
Objectives of the Study
1. To assess the role and practices of traditional birth attendants in maternal healthcare in Borno State.
2. To evaluate the training, capacity, and integration of TBAs with formal healthcare services.
3. To recommend strategies for improving maternal outcomes through enhanced TBA collaboration and training.
Research Questions
1. What roles do traditional birth attendants play in maternal healthcare delivery in Borno State?
2. How does the level of TBA training affect maternal and neonatal outcomes?
3. What measures can facilitate better integration of TBAs with formal healthcare services?
Research Hypotheses
1. TBAs with higher levels of training are associated with better maternal health outcomes.
2. Inadequate integration between TBAs and formal health systems contributes to increased maternal complications.
3. Structured training and collaboration programs will improve the safety of TBA-assisted deliveries.
Scope and Limitations of the Study
The study will focus on rural communities in Borno State where TBAs are actively involved in childbirth. Data will be collected through interviews, focus groups with TBAs, and analysis of maternal health records. Limitations include potential cultural sensitivity issues and the variability in TBA practices.
Definitions of Terms
• Traditional Birth Attendants (TBAs): Community-based, non-formally trained individuals who assist with childbirth.
• Maternal Healthcare Delivery: The provision of healthcare services to women during pregnancy, childbirth, and the postpartum period.
• Integration: The systematic collaboration between traditional and formal healthcare systems.
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