Paradox of cultural competency: Use of social marketing techniques in the 'medicalization' of granny midwives

Introduction. At the turn of the last century, infant and maternal mortality rates were astronomically high. Public health /medical approaches in infection control and in education are credited with improving the survival rates of mothers and their children. One of the strategies included the standardization of care given by midwives and involved trainings and required certifications. This session will review the history and the place of the granny midwifes within the culture of communities they served and summarize the trainings offered in terms of the levels of cultural competency and the use of social marketing techniques. The numbers of practicing midwives was markedly decreased by the required certification process as many of these gifted practitioners were not literate. Cultural proficiency and cultural humility represent one end of the spectrum of cultural competence with cultural destruction at the opposite end. This session will allow participants to assess the effects of the training on the practitioners and their communities within a framework of social justice ranking the training practices along the continuum of cultural competency.

Method. Historical literature review of the period was supplemented with of review of training manuals and teaching videos as well as a current literature review (Manual for Midwives, Mississippi State Board of Health, Underwood 1948; Trends in the Public Health activities among Negroes in 96 Southern Counties During the period 1930-1939, Cornely; The Negro: His Relation to Public Health in the South, Terry, 1912).