{"title":"\"We Only Escort Women to the Health Facility\": Traditional birth attendants and the performance of indicator-driven care in rural Tanzania.","authors":"Megan D Cogburn, Mohamed Yunus Rafiq","doi":"10.1111/maq.12917","DOIUrl":null,"url":null,"abstract":"<p><p>Global health regimes have reversed the role of traditional birth attendants (TBAs) from partners in the fight against maternal and child mortality to barriers to indicator-driven care. In rural Tanzania, widespread fear of government surveillance and punishment for non-compliant individuals and organizations that climaxed during the presidency of the late John Magufuli (2015-2021) put increased pressure on TBAs. To negotiate tensions, TBAs adopted the position that they only escort women to health facilities for birth. We argue that TBAs' insistence on this only both occludes and protects their multiple caring roles and responsibilities in a context of harsher home birth penalties, yet limited efforts to improve systemic shortages in the rural health system. TBAs' performance of \"we only escort women\" operates both as the sedimentation of policies, a way to resist them, and means to hold space for TBAs in the wake of ambiguous global and national health policies.</p>","PeriodicalId":47649,"journal":{"name":"Medical Anthropology Quarterly","volume":" ","pages":"e12917"},"PeriodicalIF":2.0000,"publicationDate":"2025-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Medical Anthropology Quarterly","FirstCategoryId":"90","ListUrlMain":"https://doi.org/10.1111/maq.12917","RegionNum":2,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ANTHROPOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Global health regimes have reversed the role of traditional birth attendants (TBAs) from partners in the fight against maternal and child mortality to barriers to indicator-driven care. In rural Tanzania, widespread fear of government surveillance and punishment for non-compliant individuals and organizations that climaxed during the presidency of the late John Magufuli (2015-2021) put increased pressure on TBAs. To negotiate tensions, TBAs adopted the position that they only escort women to health facilities for birth. We argue that TBAs' insistence on this only both occludes and protects their multiple caring roles and responsibilities in a context of harsher home birth penalties, yet limited efforts to improve systemic shortages in the rural health system. TBAs' performance of "we only escort women" operates both as the sedimentation of policies, a way to resist them, and means to hold space for TBAs in the wake of ambiguous global and national health policies.
期刊介绍：
Medical Anthropology Quarterly: International Journal for the Analysis of Health publishes research and theory in the field of medical anthropology. This broad field views all inquiries into health and disease in human individuals and populations from the holistic and cross-cultural perspective distinctive of anthropology as a discipline -- that is, with an awareness of species" biological, cultural, linguistic, and historical uniformity and variation. It encompasses studies of ethnomedicine, epidemiology, maternal and child health, population, nutrition, human development in relation to health and disease, health-care providers and services, public health, health policy, and the language and speech of health and health care.
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