Impact of a training package for community birth attendants in Madagascar.
This brief report assesses the impact of community birth attendant training and explores barriers to safe delivery in rural Madagascar. We assessed the knowledge of 25 community birth attendants using interviewer-administered questionnaires and explored attitudes to delivery in 4 focus groups of 10 women of reproductive age and 1 focus group of 10 birth attendants. We found a mismatch between hygiene knowledge and reported practice. Clinical experience appears to reinforce training to achieve longer lasting change in practitioner knowledge (e.g. of labour complications). Focus groups helped to identify practical barriers to clean (delivery kits) and safe delivery (cost) despite this knowledge. We proposed that a facilitated women's group programme may complement such training.
Faculty of Medicine and Dentistry, University of Bristol, 69 St Michael's Hill, Bristol, UK.
Olivia
O
Lucey
Mamy
M
Andriatsihosena
Matthew
M
Ellis
D005260:Female; D017144:Focus Groups; D007722:Health Knowledge, Attitudes, Practice; D006700:Home Childbirth / Q000193:education* / Q000592:standards; D006801:Humans; D007407:Interviews as Topic; D008270:Madagascar; D008875:Middle Aged; D008880:Midwifery / Q000193:education* / Q000592:standards; D007744:Obstetric Labor Complications / Q000517:prevention & control; D010342:Patient Acceptance of Health Care; D011247:Pregnancy; D015397:Program Evaluation; D012111:Residence Characteristics; D019035:Rural Health Services; D012424:Rural Population; D011795:Surveys and Questionnaires