Network linkages between TBAs and other providers having a role in childbirth care in rural Bangladesh

Abstract

Introduction: Though the number of deliveries by skilled birth attendants and at facilities has increased in Bangladesh, still many deliveries are occurring at home. More than half of all deliveries in rural areas of Bangladesh are assisted by traditional birth attendants (TBAs). Despite their critical role in maternal health, the network linkages between TBAs and other providers engaged in childbirth care in rural Bangladesh has not been well explored. Objectives: The aim of this study was to explore the coordination or communication between TBAs and other health care workers providing health care services to the women during childbirth or after delivery in rural Bangladesh. Methods: A qualitative approach was used to explore the coordination and communication between TBAs and other providers of health care services to the women during childbirth or after delivery in rural Bangladesh. Seventeen practicing TBAs, 9 “village doctors”, 8 obstetricians and 3 transport people were purposefully selected from 4 upazilas (sub-districts), in the districts of Jashore and Kushtia. Data were collected through semi-structured in-depth, individual interviews. They were conducted in Bangla and then translated and transcribed into English and analyzed. Results: Themes emerging from the interviews included TBA’s work as part of a childbirth care network, quality of care and patient safety, working relationships between TBA and village doctors, and relationship of TBA with obstetricians. Conclusion: This study explored the critical role of TBAs and other providers of their network involved in maternal health service delivery in rural areas of Bangladesh. TBAs are working in coordination with other providers. A strong referral network including TBAs will better serve mothers and newborns in rural Bangladesh.