Traditional birth attendance, HIV/AIDS and safe delivery in the Eastern Cape, South Africa: evaluation of a training

Abstract

The aim of this study was to evaluate a training programme for TBAs on HIV/AIDS and safe delivery. The sample included 50 previously untrained TBAs, with the less than 10 assisted deliveries in a year, in rural South Africa. Results indicate that TBAs had a fair knowledge on risk signs during pregnancy and on HIV/AIDS which still significantly increased after the training. While 76% of TBAs felt a great risk of HIV infection when assisting during a delivery, this significantly reduced after the training. HIV risk practices significantly reduced after the training, especially in regard to the use of gloves, a new razor blade and non-use of reed to cut the umbilical cord. Most TBAs were involved in HIV/STI management such as risk assessment, risk reduction counselling, distribution of condoms, community education and home-based care. Compared to prior to the training, after the training keeping of records of deliveries in the past 3 months and having a supply of gloves significantly increased. Prior to the training, most TBAs had pregnant women come to them, checked and advised on nevirapine, did a postpartum home visit, and advised the client on immunizations and birth control. After the training significantly more TBAs conducted prenatal check-ups, assessed the baby's position within the uterus, took the mother's and baby's pulse, and significantly less TBAs conducted abnormal or complicated deliveries.