Traditional Birth Attendants' Understanding and Perceived Roles in the Prevention of Mother to Child Transmission of HIV in Ogun State, Nigeria
Background: About 3.2 million people and 400,000 children live with HIV in Nigeria. Over 60% of deliveries take place outside health facilities and are often supervised by Traditional Birth Attendants (TBA). It is expedient that TBAs have good knowledge and perception of prevention of mother to child transmission (PMTCT) of HIV.
Methods: This is a cross-sectional study of TBAs in two randomly selected LGAs in Ogun State. All consenting TBAs registered with the TBA association in the selected LGAs were included in the study.
Result: There were 142 respondents in all. Most TBAs (97.2%) were aware of HIV and the mode of transmission. They acquired the knowledge from Government hospitals (35.2%) and the media (32.4%). The respondents were aware mothers could transmit HIV to their children during pregnancy (67.6%), labour/delivery (74.6%) and breastfeeding (62%). The perceived roles of the TBAs in PMTCT included counseling of pregnant women (95.8%), ensuring screening for HIV (95.8%), accompanying HIV positive pregnant women to centers where they can obtain care (97.2%), referral of HIV positive women (97.2%), use of universal precaution during delivery (94.4%), use of sterile instruments for delivery (98.6%) and not taking delivery of HIV positive pregnant women by themselves (78.9%).
Conclusion: The TBAs in this study had a good perception of their role in PMTCT. Persistent training and supervision will ensure compliance with the principles of PMTCT and thus reduce the burden of mother-to-child transmission of HIV.
Federal Ministry of Health. Technical Report 2008 National HIV sero-prevalence sentinel survey among women attending antenatal clinics in Nigeria. National AIDS/STI Control Programme (NASCP). Abuja, 2009.
Osuji A, Pharr JR, Nwokoro U, Ike A, Ali C, Ejiro O, Osuyali J, Obiefune M, Fiscella K, Ezeanolue EE. Impact of HIV testing and counseling (HTC) knowledge on HIV prevention practices among TBAs in Nigeria. Int J Environ Res Public Health 2015; 12: 1969-82. doi:10.3390/ijerph120201969.
Joint United Nations Programs on HIV/AIDS. Publication of specific country estimates. The Gap Report; UNAIDS: Geneva, Switzerland 2014.
Joint United Nations Programs on HIV/AIDS. Children and pregnant women living with HIV. The Gap Report; UNAIDS: Geneva, Switzerland 2014.
Federal Government of Nigeria. National policy on HIV/AIDS. October 2009
UNICEF. Children’s and Women’s Rights in Nigeria. A Wake up call, situation assessment and analysis. National Planning Commission Abuja and UNICEF, Nigeria. 2001
Population Reference Bureau and UNAIDS. HIV Institute, University of California, San Francisco. July 2009.
Inem AV, Adedokun AO, Ayankogbe OO. A Voluntary Counselling and Confidential Testing Program for Prevention of mother to Child Transmission of HIV in a Practise Based Research Network (PBRN) Hospital in Lagos, Nigeria. Nig Med Pract 2003; 43(6): 135-8.
UNAIDS. United Nations General Assembly Special Session (UNGASS), Federal Republic of Nigeria, Global AIDS Response Country Progress Report. National Agency for the Control of AIDS (NACA) Abuja, Nigeria, 2012. http://www.unaids.org/en/dataanalysis/knowyourresponse/countryprogressreports/2012countries/Nigeria%202012%20GARIR%20Report%20Revised.pdf. (Accessed Nov. 23 2013)
Federal Ministry of Health, Nigeria 2011 http://www.fmh.gov.ng/.
Inem AV, Bamgbala OA, Ayankogbe O, Robert A, Jarikre A, Grange A. Reproductive health issues arising from HIV seroprevalence study in a Voluntary Counselling and Testing program in a Nigerian Refugee Camp. Nig Med Pract 2002; 42: 28-33.
Agboghoroma CO, Sagay SA, Ikechebelu JI. Nigerian prevention of mother to child transmission of human immunodeficiency virus program: The journey so far. J HIV Hum Reprod [serial online] 2013 [cited 2015 Aug 16]; 1:1-7. Available from: http://www.j-hhr.org/text.asp?2013/1/1/1/116527
Iwelunmor J, Ezeanolue EE, Airhihenbuwa CO, Obiefuwe MC, Ezeanolue CO, Ogedegbe GG. Socio-cultural factors influencing the prevention of mother to child transmission of HIV in Nigeria: a synthesis of the literature. BMC Public Health 2014, 14:771. Doi:10.1186/1471-2458-14-771
Wikipedia contributors, 'Ijebu Ode', Wikipedia, The Free Encyclopedia, 24 June 2015, 12:40 UTC, <https://en.wikipedia.org/w/index.php?title=Ijebu_Ode&oldid=668460665> [accessed 16 August 2015]
Itina SM. Characteristics of TBAs and their Beliefs and Practises in the Offot Clan, Nigeria. Bull World Health Org 1997; 75(6): 563-7.
Peltzer K, Phaswana-Mafuya N, Treger L. Use of traditional and complementary health practices in prenatal, delivery and postnatal care in the context of HIV transmission from Mother to Child (PMTCT) in the Eastern Cape, South Africa. Afr J Trad Complement Altern Med 2009; (6):155-62.
Kamal IT. The traditional birth attendant: a reality and a challenge. Int J Gynecol Obstet 1998; 63: S43-S52.
Balogun M, Odeyemi K. Knowledge and practice of Prevention of Mother to Child Transmission of HIV among Traditional Birth Attendants in Lagos State Nigeria. Pan Afr Med J 2010; 5; 7
Gill CJ, Phiri-Mazala G, Guerina NG, Kasimba J, Mulenga C, MacLead WB, Waitolo N, Knapp AB, Mirochnick M, MazimbaA, Fox MP, Sabin L, Seidenberg P, Simon JL, Hamer DH. Effect of training Traditional Birth Attendants on neonatal mortality (Lufwanyama Neonatal Survival Project): Randomised Control Study. BMJ 2011 Posted 03/01/2011.
Federal ministry of health. National guidelines on prevention of mother to child transmission of HIV in Nigeria. National AIDS-STI Control Programme (NASCP). Abuja. 2005.
Nkwo PO. Prevention of mother to child transmission of Human Immunodeficiency Virus: The Nigerian perspective. Ann Med Health Sci Res. 2012; 2(1)58-65.
Bassey EB, Elemuwa CO, Anukam KC. Knowledge of and attitude to Acquired Immunodeficiency Syndrome (AIDS) among Traditional Birth Attendants (TBAs) in rural communities in Cross River State, Nigeria. Int Nursing Rev 2007; 54:354-58.
National Population Commission (NPC) Nigeria and ICF International. Nigeria Demographics and Health Survey 2013; NPC and ICF International: Abuja, Nigeria, 2014.
Kaingu C, Oduma JA, Kanui TI. Practices of Traditional Birth Attendants in Machakos District, Kenya. J Ethnopharmacol 2011. doi:10. 1016/j.jep 2011.05.044.
Ejikeme BN, Umeora OUJ, Obuna JA. Utilization of maternal health services at the secondary health level in a limited-resource setting. Nig Med Pract 2007; 51(112): 6-10.
Madhivanan P, Kumar BN, Adamson P, Krupp K. Traditional Birth Attendants lack Basic Information on HIV and Safe Delivery Practices in Rural Mysore, India. BMC Public Health 2010, 10: 570. doi: 10.1816/1471-2458-10-570.
Wanyu B, Diom E, Mitchell P, Tih PM, Meyer DJ. Birth Attendants Trained in “Prevention of Mother-to-Child HIV Transmission” provide care in rural Cameroon, Africa. J Midwifery Women Health 2007; 52: 334-41.
Homsy J, King R, Balada D, Kabatesi D. Traditional Health Practitioners are key to scaling-up comprehensive care for HIV/AIDS in Sub-Saharan Africa. AIDS 2004; 18:1723-5.
Bulterys M, Fowler MG, Shaffer N, Tih PM, Greenberg AE, Karita E, Coovadia H, De Cook KM. Role of Traditional Birth Attendant in preventing perinatal transmission of HIV. BMJ 2002; 34 (7331): 222-25.
The articles and other materials published in the Annals of Health Research are protected by the Nigerian Copyright laws. The journal owns the copyright over every article, scientific and intellectual materials published in it. However, the journal grants all authors, users and researchers access to the materials published in the journal with the permission to copy, use and distribute the materials contained therein only for academic, scientific and non-commercial purposes.