Traditional birth attendant training programs in low resource countries: an integrative literature review

IF 2.6 3区医学 Q1 NURSING

Midwifery Pub Date : 2025-07-16 DOI:10.1016/j.midw.2025.104532

Sara David , Zoe Bradfield , Yvonne Hauck , Michelle A Kelly

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引用次数: 0

Abstract

Background

: Pregnant women continue to die from preventable causes, the greatest number in low-resource countries, where neglect of Traditional Birth Attendant [TBA] training is adversely affecting women with the least access to family planning or a Skilled Birth Attendant. Consideration for TBAs role to strengthen maternity care in low resource settings is recommended. The scope of the TBA role, appropriate training and supervision remains a challenge.

Aim

: This integrative literature review analysed publications about TBA training programs in low-resource countries.

Methods

: A search strategy was implemented incorporating a five-step framework utilising electronic databases. Twenty- five publications were reviewed. Four themes and eleven sub-themes were identified about “TBA training programs in low-resource countries”: (1) Variance in role of TBAs affecting training including subthemes of variance in role, scope and title of TBAs, appointment and remuneration, and articulation of TBA work; (2) Training influenced by where TBAs provide services including areas of high Maternal and Neonatal Mortality, and with low access to health; (3) Educational needs of TBAs, including lack of consensus around specific knowledge and skills, need for culturally appropriate educational needs assessment and importance of education about role of health facilities and referral process; (4) Training and teaching TBAs, including methods, cultural contexts and resources.

Discussion

: There is global confusion about TBA’s role within maternity services in low-resource countries, including their title, scope of practice, remuneration, specific training needs and required clinical skills. Community engagement to ensure a culturally applicable role for TBAs, appropriate training information and materials is imperative to ensure sustainability and effectiveness. A gap in knowledge exists around measurable outcomes related to training programs. Recommendations are offered to incorporate TBAs into the maternity healthcare system for low resource settings.

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低资源国家传统助产士培训项目：综合文献综述

背景：孕妇继续死于可预防的原因，在资源匮乏的国家死亡人数最多，在这些国家，忽视传统助产士[TBA]培训对获得计划生育或熟练助产士机会最少的妇女产生了不利影响。建议考虑传统助产士在资源匮乏环境中加强产妇护理的作用。TBA的作用范围、适当的培训和监督仍然是一个挑战。目的：本综合文献综述分析了低资源国家TBA培训计划的出版物。方法：利用电子数据库实现了一个包含五步框架的搜索策略。对25份出版物进行了审查。在“资源匮乏国家TBA培训项目”中，确定了4个主题和11个副主题：(1)影响培训的TBA角色差异，包括TBA角色差异、TBA范围和头衔差异、TBA任命和薪酬差异以及TBA工作表达差异；(2)培训受传统助产士提供服务地点的影响，包括产妇和新生儿死亡率高和获得保健机会少的地区；(3)传统助产士的教育需求，包括对具体知识和技能缺乏共识，需要进行文化上适当的教育需求评估，以及对卫生设施和转诊过程的作用进行教育的重要性；(4)培训和教学tba，包括方法、文化背景和资源。讨论：全球对TBA在低资源国家产科服务中的作用存在混淆，包括其名称、执业范围、报酬、特定培训需求和所需临床技能。社区参与以确保传统贸易机构发挥文化上适用的作用，适当的培训信息和材料是确保可持续性和有效性的必要条件。在与培训项目相关的可衡量结果方面存在知识差距。建议将tba纳入低资源设置的产妇保健系统。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Midwifery 医学-护理

CiteScore

4.50

自引率

7.40%

发文量

221

审稿时长

13.4 weeks

期刊介绍： Midwifery publishes the latest peer reviewed international research to inform the safety, quality, outcomes and experiences of pregnancy, birth and maternity care for childbearing women, their babies and families. The journal’s publications support midwives and maternity care providers to explore and develop their knowledge, skills and attitudes informed by best available evidence. Midwifery provides an international, interdisciplinary forum for the publication, dissemination and discussion of advances in evidence, controversies and current research, and promotes continuing education through publication of systematic and other scholarly reviews and updates. Midwifery articles cover the cultural, clinical, psycho-social, sociological, epidemiological, education, managerial, workforce, organizational and technological areas of practice in preconception, maternal and infant care. The journal welcomes the highest quality scholarly research that employs rigorous methodology. Midwifery is a leading international journal in midwifery and maternal health with a current impact factor of 1.861 (© Thomson Reuters Journal Citation Reports 2016) and employs a double-blind peer review process.