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首页> 外文期刊>The Internet Journal of Tropical Medicine >Traditional Birth Attendants: Practices & Problems In Konduga Local Government Area Of Borno State; North Eastern Nigeria
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Traditional Birth Attendants: Practices & Problems In Konduga Local Government Area Of Borno State; North Eastern Nigeria

机译：传统接生员：博尔诺州Konduga地方政府所在地的做法和问题;尼日利亚东北

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Background: Significant number of deliveries in the developing world takes place at home mostly conducted by traditional birth attendants. Some of their practices are harmful and contributes significantly to morbidity and mortality especially if untrained. This study was carried out to document harmful practices, training status and problems of the traditional birth attendants in Konduga Local Government Area of Borno State, North Eastern Nigeria.Methods: Data was collected based on a proforma questionnaire administered to traditional birth attendants by final year medical students supervised by consultant staff from departments of paediatrics and Community Medicine of the University of Maiduguri.Results: There were a total of 48 traditional birth attendants (TBAs) spread across the 5 districts of Konduga Local Government. Forty six (95.8%) were aged ≥ 35years with only 2 (4.2%) below age 35 years. Only 12 (25%) TBAs had some form of training while 36 (75%) did not have any form of training. All the trained TBAs sterilize their delivery kits before any delivery. Cord was severed using a new razor blade by 44 (91.7%) of the TBAs, 3 (6.3%) used bamboo or back of corn stick, while one (2.1%) used a pair of scissors. Various items used in securing the cord includes tie with thread 38 (79.2%), massage and application of warm or cold water before cutting 5 (10.4%), tie with string 3 (6.3%) and soak in dettol 2 (4.2%). Difficulties encountered by the TBAs during conduct of deliveries includes retained placenta 4 (8.3%), breech delivery 4 (8.3%), lack of facilities 2 (4.2%), obstruction 2 (4.2%), antenatal bleeding 1 (2.1%), all of the above 1 (2.1%) and none 34 (70.8%). When asked if they know of a child who have died as a result of stiffness during the cord care period, 23 (47.9%) said yes while 25 (52.1%) said no. Twenty five (52.1%) said it is not too common, 3 (6.3%) said it is common, only 1 (2.1%) said it is very common, while 19 (39.6%) said they have not seen or are not aware of the illness. Eleven (22.9%) of the TBAs saw about 1-2 cases of children dying of stiffness in the last one month, 2 (4.2%) saw 3 and above of such cases, while 35 (72.9%) said they have not seen any of such cases in the last one month.When asked what danger they think can result from not taking proper care of the cord, 18 (37.5%) said sickness /death, 14 (29.2%) said abdominal distention or perforation, 6 (12.5%) said stiffness, 5 (10.4%) said poor cord healing while 5 (10.4%) said they don’t know.Conclusion: In conclusion, there are few facilities and skilled attendants in Konduga Local Government Area to manage normal deliveries and diagnose, manage or refer obstetric and neonatal complications. There is therefore the need for training and retraining of TBAs on safe delivery and good cord care practices. The development of an effective referral system for referral of complicated deliveries and newborn problems needs serious consideration. This will go a long way in lowering the high maternal and neonatal mortality with subsequent lowering of perinatal mortality rates.
机译：背景：在发展中国家，大量分娩主要由传统接生员在家进行。他们的某些做法是有害的，尤其是在未经培训的情况下，会大大增加发病率和死亡率。本研究旨在记录尼日利亚东北部博尔诺州Konduga地方政府区传统接生员的有害作法，培训状况和问题。方法：数据收集基于对去年传统接生员的形式问卷调查迈杜古里大学儿科和社区医学系的顾问人员对医学生进行了监督。结果：在Konduga地方政府的5个地区中共有48名传统接生员（TBA）。年龄在35岁以上的人有46名（95.8％），在35岁以下的只有2名（4.2％）。只有12个（25％）TBA接受了某种形式的培训，而36个（75％）没有进行任何形式的培训。所有训练有素的TBA在交付之前都会对其交付工具包进行消毒。使用新的剃刀刀片将脐带割断了44个（91.7％）的TBA，其中3个（6.3％）使用了竹子或玉米棒的后背，而一个（2.1％）使用了一把剪刀。用来固定绳索的各种物品包括：用线38扎带（79.2％），按摩和在切割5根之前用温水或冷水（10.4％），用线3系扎（6.3％）并浸入滴露2中（4.2％） 。 TBA在分娩过程中遇到的困难包括胎盘滞留4（8.3％），臀位分娩4（8.3％），设施不足2（4.2％），阻塞2（4.2％），产前出血1（2.1％），以上所有1（2.1％）都不是34（70.8％）。当被问及是否知道一个孩子在脐带护理期间因僵硬而死亡时，有23人（47.9％）表示同意，而25人（52.1％）表示否。 25（52.1％）表示不太常见，3（6.3％）表示很常见，只有1（2.1％）表示很常见，而19（39.6％）表示没有看到或不清楚的疾病。在过去的一个月中，有11个（22.9％）的TBA约有1-2例儿童死于僵硬，其中2个（4.2％）的儿童中有3个及以上的案例，而35个（72.9％）的儿童未见任何僵化当被问及他们认为不适当护理脐带会导致何种危险时，18（37.5％）说疾病/死亡，14（29.2％）说腹胀或穿孔，6（12.5 ％）表示僵硬，其中5（10.4％）表示脐带愈合不良，而5（10.4％）表示不知道。结论：总而言之，Konduga地方政府地区几乎没有设施和熟练的服务员来管理正常分娩和诊断，管理或转诊产科和新生儿并发症。因此，需要对TBA进行有关安全分娩和良好的脐带护理规范的培训和再培训。为复杂的分娩和新生儿问题的转诊建立有效的转诊系统需要认真考虑。这将在降低较高的孕产妇和新生儿死亡率以及随后降低围产期死亡率方面大有帮助。

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