Roles and Challenges of Traditional Birth Attendants in Prevention of Mother to Child Transmission o

Introduction: Approximately 65% of deliveries in Nigeria (including women with HIV) take place in settings such as conventional birth attendants (TBAs). Although there are some difficulties with TBA participation in PMTCT, their success stories of increased HIV therapy and testing (HCT) uptake among pregnant women remain a cause for training, overseeing and effectively incorporating them into formal health centers and meeting the target population of PMTCT. This is a brief overview of traditional birth attendants' positions and challenges in the prevention of HIV transmission from mother to child in Nigeria.

Methods: MTCT, PMTCT and TBA are keywords from the analysis goals used to search for similar literature through online libraries such as medline and pubmed, like google, national and international journals. Initially, approximately 62 associated literature/studies were developed and then narrowed down to 21 literatures chosen because they met the inclusion requirements of less than 10 years and relevant to the review objective.

Findings: Since 65% of deliveries take place in non-formal settings such as TBAs, they are predominantly trained/engaged to participate in PMTCT by NGOs. Improved PMTCT awareness and procedures after training (p = 0.01) and improved HCT adoption at the TBAs (p = 0.001) are big success stories. Low levels of education, inability to refer HIV-positive patients in the absence of incentives, inadequate monitoring systems and low quality evaluation/supervision are major challenges. Currently, national proposals for accelerated PMTCT and the removal of MTCT advise that TBAs be incorporated into formal health centers in order to meet the target population further and fill the Nigerian PMTCT gap.

Conclusion: TBAs have the ability to bridge the gap between formal distribution points for PMTCT and the cultural communities in which most pregnant women, the target population, reside. While TBA participation challenges are evident, support for TBA training/retention and quality assessment/supervision may be the response to the challenges of achieving the PMTCT target group and achieving the PMTCT target in Nigeria.

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