REPORT OF 3 DAYS TRANING FOR TRADITIONAL BIRTH ATTENDANTS (TBAs) IN KABUSA COMMUNITY ON SAFE MOTHERHOOD AND INFECTION CONTROL DURING DELIVERY, JUNE 11-13TH, 2009.

The need for requisite capacity building for Traditional Birth Attendants in providing safe motherhood and infection control during delivery is a Sine qua non for the attainment and actualization of key Millennium Development Goals (MDG5). This underscored the support of African Women Development Fund (AWDF), to Center for Right to Health on 11th-13th June, 2009 to organize a 3 days workshop in Kabusa Community. The venue for the workshop was PHC Ketti, located along Sheratti road Kabusa.


The workshop aimed at Educating TBAs on how to ensure quality pre-natal and Post natal care also improve maternal and child health of women in rural communities.

The Specific Objectives of the Workshop were to:

• Improve the knowledge and skills of 20 Traditional Birth Attendants and Midwives.
• Empower the TBAs on how to build a trusting relationship with clients helping them to reduce their risk to infection, HIV and STDs.
• Empower them on how to make pregnancy, labour and delivery safe.
• Educate them on how to deal with women of unknown HIV infection, preventing and dealing with obstetric emergencies.
• Educate them on the importance of Immunization and how to prevent the Child & Mother from contacting diseases.
• Educate them on different methods of counseling on safer feeding options

The workshop had the capacity of Twenty Four (25) TBAs, including Health Workers and Midwives as participants and three (3) Medical experts as facilitators. Each of the participants were allowed to interact freely with the medical experts, sharing their personal experience and challenges. The workshop commenced from 10am-3pm daily for 3 days.

The participants expressed their expectations as:

• To learn new skills on how to attend to pregnant women
• To mobilize their peers and transfer these skills learnt.
• To get more information on how to control infections during and after delivery
• To learn how to prevent themselves from contacting diseases while doing their jobs.
• To gather information on when, to refer their clients to hospital


Topics discussed at the workshop include:

1. The role of TBAs in maternal mortality reduction in rural community: This topic examined the importance of TBAs in maternal mortality reduction in rural community.

2. An over view of the stages of labour: This emphasized more on the different stages of labour :

Ist stage: Labour

2nd Stage: Delivery

3rd Stage: Extraction of Placenta

The Facilitator emphasized the following

• If labour exceed 12hours , the TBAs should refer the patient to hospital
• If placenta takes more than 30 minutes to come out , the TBA should refer the patient to hospital
• The TBA should examine and ensure that all the lobes are out, if there is any retained placenta, the TBA should refer the patient to hospital.

3. Infection Control During Labour and Delivery: This topic gave an insight to:

• Environmental hygiene
• Hand washing before and after rendering service
• Use of hand gloves
• Use of antiseptic
• Avoid unsterelized objects

4. Immediate Assessment of Newborn and Mother: This topic explored the need to check the new born and mother after birth.

5. Immunization of an infant to ensure protection from diseases: Participants were taught the different stages and its mode of prevention for instances, at Birth

Hepatitis B and Oral Polio should be administered. At 6 weeks , Oral Polio , Hepatitis B, Diphtheria, Tetanus & Pertusis, Haemoopilus influenzae type B , Rotavirus (Diarrhea & Vomiting). At 10 weeks: Oral Polio, DTP, HIB, and Rotavirus. At 14weeks: Oral Polio (OPV) Hepatitis B, DTP and HIB. At 6 months: Vitamin A, at 9months Measles and yellow fever. At 12-15months Measles, Mumps Rubella and Chicken pox. At 18 months DTP (Booster) and OPV (Booster). At 2 yrs Typhoid Fever and Meningitis. Participants were asked to encourage nursing mothers to observe all these stages.

6. Referral Network System in the Community: The TBAs were taught the importance of referral and the need for time management while referring. Different referral networks and locations were identified and the TBA(s were encouraged to note and make maximum use of these centers.

The following questions were asked by the participants:

• How to manage the crises of pain after delivery?

Response: Participants were told to use a towel deep in a warm water and press on the stomach of the patient. Participants were told to avoid the use of dry gin etc. Participants were advised that if pain persists, they should administer paracetamol .

• How to Clean Navel of an infant to avoid contamination of disease?

Response: Participants were advised to use spirit and cotton wood and clean it every 5mins of the day. Participants were advised to avoid the use of warm water or Vaseline in cleaning the baby Navel

• How to manage the crisis of Umbilical cord tying round the baby’s neck?

Response: Participants were asked to use thread since they don’t have the modern equipments used in the hospital. The thread should be tied both side then cut.

Challenges
- All presentation was made principally in Gbagi and Hausa dialect. This led in paying extra cost to the facilitators.
- Lack of power supply which necessitated the hiring of Generator for the three days.
- A prominent man in the community died on the third day of the training. This led to the shifting of the training to Monday 15th of June. There by leading to more financial expenses on the part of the center.
- The center have extra five people from Ketti (5) added to the previous budget made.

Finally, one of the spokes women among the TBAs by name Madam Sarah expressed her gratitude towards CRH and prayed that more funds should be given to ensure sustainability and expansion of the project to other communities near Kabusa. The workshop came to an end at about 3pm on Monday the 15th of June, 2009.

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