Traditional Birth Attendant Training and Improving Maternal Newborn Care in Rural Haiti

In Haiti, women and their babies are at great risk. Haiti ranked 132 of 171 countries on maternal mortality—before the earthquake. Neonatal mortality is 32/1000. These poor statistics are in large part due to the fact that seventy-five percent of births take place at home with assistance from a traditional birth attendant, with home births even more common in rural areas. Home births are likely to increase in the aftermath of the earthquake and the loss of the country's only nurse midwifery school in Port au Prince. HHF supervises 362 Matwons (TBAs), 75% are female, 186 received HBLSS training and 194 have certificates of TBA training. Delivery outcomes were analyzed by TBA age, gender, and training. Qualitative data from 23 matwons informed the results. TBA training, especially Home Based Life Saving Skills (HBLSS), resulted in improved outcomes. Recommendations include improving TBA skills and providing auxiliary nurse midwife training for the next generation of TBAs. The only nurse midwifery school in Haiti was destroyed in the earthquake. Nurse midwifery schools should be developed in all regions of the country. Trained and supervised TBAs, HBLSS, nurse and auxiliary nurse midwives will help Haiti rebuild health care resources and reduce maternal newborn mortality.