International maternal mortality reduction: outcome of traditional birth attendant education and intervention in Angola.
BACKGROUND
As a result of war and periodic natural disasters, Angola has among the highest infant and maternal mortality rates in the world. In response to the acute health needs of the population, the International Medical Corps (IMC) developed a traditional birth attendant educational course designed to reduce the preventable causes of maternal and infant mortality.


METHODS
From 1994 until 1998, Angolan traditional birth attendants (TBAs) participated in an intensive 38-hr training course on prenatal, delivery, and postnatal care. Following the birth of a child, the trained TBAs completed a registration form containing information regarding the health of the mother. Previous studies of Angolan maternal mortality served as historic comparisons.


RESULTS
Complete data including maternal mortality data were available for 19,666 deliveries (83% of total). Fifty five maternal deaths were recorded, which corresponds to a maternal mortality rate of 293 per 100,000 live births. The average historic maternal mortality rate for available comparison groups was 1241 per 100,000 live births.


CONCLUSIONS
The maternal mortality rate was reduced among women managed by IMC-trained TBAs when compared with historical control data.
Schaider
J
J
Department of Emergency Medicine Cook County Hospital/Rush University Medical College, Chicago, IL, USA.
Ngonyani
S
S
Tomlin
S
S
Rydman
R
R
Roberts
R
R
D000810:Angola; D036861:Delivery, Obstetric; D005260:Female; D014943:Global Health; D006301:Health Services Needs and Demand; D006801:Humans; D007224:Infant Care; D007226:Infant Mortality; D007231:Infant, Newborn; D008428:Maternal Mortality; D008429:Maternal Welfare; D008880:Midwifery / Q000193:education*; D011181:Postnatal Care; D011247:Pregnancy; D011295:Prenatal Care