From home deliveries to health care facilities: establishing a traditional birth attendant referral program in Kenya.
J Health Popul Nutr
; 33: 6, 2015 Jul 16.
Article
en En
| MEDLINE
| ID: mdl-26825288
ABSTRACT
OBJECTIVE:
To assess the effectiveness of a traditional birth attendant (TBA) referral program on increasing the number of deliveries overseen by skilled birth attendants (SBA) in rural Kenyan health facilities before and after the implementation of a free maternity care policy.METHODS:
In a rural region of Kenya, TBAs were recruited to educate pregnant women about the importance of delivering in healthcare facilities and were offered a stipend for every pregnant woman whom they brought to the healthcare facility. We evaluated the percentage of prenatal care (PNC) patients who delivered at the intervention site compared with the percentage of PNC patients who delivered at rural control facilities, before and after the referral program was implemented, and before and after the Kenya government implemented a policy of free maternity care. The window period of the study was from July of 2011 through September 2013, with a TBA referral intervention conducted from March to September 2013.RESULTS:
The absolute increases from the pre-intervention period to the TBA referral intervention period in SBA deliveries were 5.7 and 24.0% in the control and intervention groups, respectively (p < 0.001). The absolute increases in SBA delivery rates from the pre-intervention period to the intervention period before the implementation of the free maternity care policy were 4.7 and 17.2% in the control and intervention groups, respectively (p < 0.001). After the policy implementation the absolute increases from pre-intervention to post-intervention were 1.8 and 11.6% in the control and intervention groups, respectively (p < 0.001).CONCLUSION:
The percentage of SBA deliveries at the intervention health facility significantly increased compared to control health facilities when TBAs educated women about the need to deliver with a SBA and when TBAs received a stipend for bringing women to local health facilities to deliver. Furthermore, this TBA referral program proved to be far more effective in the target region of Kenya than a policy change to provide free obstetric care.
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Atención Prenatal
/
Derivación y Consulta
/
Aceptación de la Atención de Salud
/
Atención Perinatal
/
Servicios de Salud Rural
/
Parto Domiciliario
/
Partería
Tipo de estudio:
Clinical_trials
/
Prognostic_studies
/
Sysrev_observational_studies
Límite:
Adult
/
Female
/
Humans
/
Pregnancy
País/Región como asunto:
Africa
Idioma:
En
Revista:
J Health Popul Nutr
Asunto de la revista:
CIENCIAS DA NUTRICAO
/
GASTROENTEROLOGIA
/
SAUDE PUBLICA
Año:
2015
Tipo del documento:
Article
País de afiliación:
Estados Unidos