A co-designed conceptual educational framework for midwives to train Indigenous traditional birth attendants in low resource settings of remote Papua New Guinea.

Abstract

Problem: In remote Papua New Guinea there are few midwives or functioning health facilities, and high perinatal mortality. Indigenous traditional birth attendants carry the burden of caring for women and newborns.

Background: Midwives training and developing traditional birth attendants rely on ad-hoc approaches to the education they provide, drawing from their own knowledge and skills.

Aim: Develop a culturally sensitive conceptual educational framework as a guide for midwives to train and supervise traditional birth attendants in low-resource settings.

Methods: Seven-step approach: 1) Establish trust and respect; 2) Identification of the need; 3) Ethical considerations; 4) Needs analysis; 5) Contextual considerations; 6) Theoretical framework; 7) Practice standards.

Findings: The Yamen Traditional Birth Attendant Conceptual Educational Framework guides midwives to train and supervise traditional birth attendants to strengthen maternal and newborn healthcare in low-resource settings through pre-service education and community development. Four adult, cross-cultural learning principles were identified: cultural sensitivity, strategic issues, previous experience, evidence-based practice. Expected outcomes include increased knowledge, skills, attitudes, and critical thinking of traditional birth attendants.

Discussion: Training and supervision of traditional birth attendants by midwives is recommended for low-resource settings of Papua New Guinea to foster strong partnerships between communities and health facilities and improve perinatal safety.

Conclusion: A co-designed, culturally sensitive education framework is presented with the potential to strengthen maternal and newborn services in low-resource settings by linking traditional birth attendants to midwives in formal health services. Further research is needed to articulate the role, scope of work and key learning competencies.