Roles of Traditional Birth Attendants and Perceptions on the Policy Discouraging Home Delivery in Coastal Kenya

Objectives: To describe the roles of Traditional Birth Attendants (TBAs), to determine the perceptions of TBAs and Skilled Birth Attendants (SBAs) towards the policy discouraging home delivery by TBAs and to establish the working relationship between TBAs and SBAs in Kwale, Kenya.Design: Community based cross-sectional study.Setting: Mwaluphamba, Kinango and Golini locations of Kwale County, Kenya.Subjects: Fifty eight participants were involved in the study. Interviews were conducted with 22 TBAs and 8 SBAs as well as 3 FGDs with 28 TBAs were carried out in July 2012.Main outcome measures: Roles of TBAs, policy awareness and support as well as the working relationship between TBAs and SBAs.Results: Before delivery, the main role of TBAs was checking position of the baby in the womb (86%) while during delivery, the main role was stomach massage (64%). However, majority (95%) of the TBAs did not provide any after delivery. All SBAs and 59% of TBAs were aware of the policy while 88% SBAs and 36% of TBAs supported it. The working relationship between TBAs and SBAs mainly involved the referral of women to health facilities (HFs). Sometimes, TBAs accompanied women to the HFoffering emotional support until after delivery.Conclusion: TBAs in Kwale have a big role to play especially during pregnancy and delivery periods. Awareness and support of the policy as well as the collaboration between SBAs and TBAs should be enhanced in Kwale