Using Culture Results from Hands and Razor Blades to Sensitise Traditional Birth Attendants (TBAs) on Infection Prevention Practices
Keywords:
Hand Washing, Traditional Birth Attendants, Infection Prevention, Health Education, Teaching Strategies, Puerperal Sepsis, Neonatal Sepsis
Abstract
This article describes findings from one component of a multi-phased study on infection prevention knowledge and practices of Traditional Birth Attendants (TBAs) from 2006-2012. The study included two activities within the training programme for TBAs, using a modified Ministry of Health (MoH) TBA Training Curriculum. One component of this curriculum involved sensitising the TBAs on two poor infection prevention practices - poor hand washing and cutting babies’ umbilical cords using any dirty, rusted, sharp instrument after tying it with traditional ulushishi (fibre from inside of tree bark). These practices cause maternal and infant morbidities. Seventy-eight out of one hundred intervention TBAs, whose right hands were swabbed for laboratory analysis, were chosen by simple random sampling. The training had theoretical and practical components. They were trained in four groups consisting of twenty-five TBAs in each group. The results showed no growth on the six razor blades after forty-eight hours of incubation, thus proving their sterility. The results from the hand swabbing showed one-hundred and seven isolates that can potentially infect mothers and babies during the birthing process. This result convinced the TBAs on the importance of hand washing. This was evidenced after the training, because the proportion of TBAs who washed their hands before delivering their clients, among the intervention group, was significantly different (p<0.001) compared to the control group (52) 48.6 per cent. Increased evidence-based hand washing and using sterile blades in Clean Delivery Kits (CDKs), during deliveries may have reduced infant and maternal infection rates among the intervention TBAs. Therefore, the results would inform the infection prevention policy on evidence-based practices. Although this sensitisation contributed to evidence-based hand washing practices, among TBAs and the subsequent lowering of the TBA clients’ morbidity rates in the Chongwe district, this study needs replication in other rural communities.References
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2. Boyce J.M. & Didier P. (2002): Guidelines for Hand Hygiene in Health Care Settings www.cdc.gov/mmwr/preview/mmwrhtml/rr5116a1.htm (Accessed on 11/04/2014)
3. Programe For Appropriate Technology In Health (PATH), (2001) Basic Delivery Kit Guide: Commitment To Improving Clean Delivery Practices
Http://Www.Path.Org/Publications/Files/Mchn_Bdkg.Pdf (Accessed on 7/4/2014).
4. Chongwe District Health Management Board (2006): Chongwe Action Plan, Chongwe.
5. Hazemba, A. & Siziya R. (2007): Utilisation of Maternity Care Services Offered by Traditional Birth Attendants in Chongwe Rural District. Medical Journal of Zambia, 34 (3):125-129.
6. Mugala, N., & Nwinga. K.,(2006): Comparative Study in Integrated Management of Childhood Illnesses, Lusaka.
7. Sibley L.M & Sipe T A. (2004): Training TBAs Linked to Small but Significant Reduction in Newborn Mortality, Journal of Midwifery., Vol: 20 51-60, Elsevier Science Publishers. London, England.
8. Chanda, D., (2004): An Infection Prevention Manual for Community and the Health Care Institutions in Developing Countries. Maiden Publishing House, Lusaka, Zambia.
9. Akutse A. (2004): The Risks of HIV/AIDS Transmission by TBAs Practices in Villages. 15th International AIDS Conference, Bangkok, Thailand.
10. Hernández, G., Norma Araceli Coello N. A., Arita De Fu M., Cantarero E.,(2004); Training Plan For Traditional Birth Attendants and Maternal Health Aides. http://www.coregroup.org/storage/documents/Diffusion_of_Innovation/training_plan_for_TBAs.pdf (accessed on 5/4/2014
11. Swai, E and Glinami.,( 2011), Forgotten Voices, Knowledge Creation and Gender Relations in Tanzania. http://www.general.assembly.codesria.org/IMG/pdf/Glinami_Swai.pdf (Accessed on 01/03/2012).
12. Maimbolwa M. C. (2004): Maternity Care in Zambia. With Special Reference to Social Support. Reproprint AB.
13. Jokhio, Abdul Hakeem; Winter, Heather R. & Cheng, Kar Keung, (2005): Obstetrical & Gynecological Survey: Vol., 60 ( 10): 641-642. http://journals.lww.com/obgynsurvey/Abstract/2005/10000/An_Intervention_Involving_Traditional_Birth.11.aspx. (Accessed on 01/06/2011).
14. Fronczak, N., S.E. Arifeen, S. E., A.C. Moran,A. C., Caulfield, L. E. & Baqui A. H., (2007); Delivery Practices of Traditional Birth Attendants in Dhaka Slums, Bangladesh. J Health Popul Nutr.;Vol., 25(4): 479–487.
15. CAFOD.org (2013) http://www.cafod.org.uk/News/Emergencies-news/Next-generation,2013, (accessed on 5/4/2014).
16. World Health Organization (2012). Maternal .Mortality. http://www.who.int/mediacentre/factsheets/fs348/en/index.htmlAPPENDIX. (accessed on 5/4/2014).
17. Gibson M., Bowles, C. B., Jansen,,L., Leach, J., (2013): Childbirth Education in Rural Haiti: Reviving Low-Tech Teaching Strategies(2013): Journal of Perinat Educ.22(2): 93–102. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3647738/ accessed on 5/4/2014.
18. Ministry of Health/Central Board of Health, (2002); Annual Health Report, Ndeke House, Lusaka.
19. Chanda, D.O. (2013); The Impact of Using a Modified Ministry of Health Traditional Birth Attendant Training Curriculum on the Infection Prevention Knowledge, Practice and Attitude of Trained Traditional Birth Attendants in Chongwe District of Zambia. dspace.unza.zm:8080/xmlui/bitstream/handle/.../Chanda%20D..pdf?...1
http://www.panapress.com/HiV-AiDS--WHO-urges-strengthening-of-traditional-health-workers-role--12-573037-66-lang2-index.html
20. Chongwe District Health Management Board, (2007); (Medium Term Expenditure Framework (MTEF) Action Plan and Budget for 2005-2007).
21. Chongwe Rural Health Center Out Patient’s Report, 2006).
22. Brooks G. F., Carroll K. C.,Butel J.S.Morse A.S.Mietzner A. T. (2010): Jawetz, Melnick and Adelbergs Medical Microbiology, 25th edition. The McGraw-Hill Companies Inc, New York.
23. Spicer J. W. (2008), Clinical Microbiology and Infectious Diseases, 2nd Edition Churchill LivingstoneElservier
24. Butlerys M. Fowler MG, N. Shaffer, Tih PM, Greenberg AE, E. Karita, Coovadia H, & de Cock KM., (2002): The Role of Traditional Birth Attendants in Preventing Perinatal Transmission of HIV. BMJ Vol.324:222
25. Hill, Z; Tawiah-Agyemang C; Okeyere C, ; Manu E, Alexander; Fenty, J., Kirkwood, B ( 2010); Improving Hygiene in Home Deliveries in Rural Ghana: How to Build on Current Attitudes and Practices. Paediatric Infectious Disease Journal: Vol. 29 – Issue 11. Pp 1004-1008
Published
2023-05-25
How to Cite
1.
Chanda D, Siziya S, Baboo K, Michelo C. Using Culture Results from Hands and Razor Blades to Sensitise Traditional Birth Attendants (TBAs) on Infection Prevention Practices. Journal of Agricultural and Biomedical Sciences [Internet]. 25May2023 [cited 2Jul.2025];6(3). Available from: https://journals.unza.zm/index.php/JABS/article/view/832
Section
Biomedical Sciences
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