Impact of training Traditional Birth Attendants on maternal and infant mortality in the Philippines

In 1958, the Philippines Republic Act 2644, An Act Regulating Midwifery Training and Practice, authorized Traditional Birth Attendants to practice in areas not served by professional health workers. The Department of Health of the Philippines began conducting training programs for Traditional Birth Attendants with UNICEF. Trainings concerned sterile techniques and germ theory, in attempts to reduce infant and maternal mortality. Nationally, trained Traditional Birth Attendants and doctors attended approximately the same number of deliveries in 2004. However, for the past three years the Department of Health of the Philippines has ceased these trainings.

Maternal and infant mortality were assessed in four municipalities comparing the outcomes of deliveries of trained versus untrained Traditional Birth Attendants. Training of Traditional Birth Attendants in sterile technique and improvements in pre-natal care demonstrate a marked reduction in maternal and infant mortality. Twenty Traditional Birth Attendants were non-randomly selected through snowball and convenience sampling for semi-structured interviews. The majority of Traditional Birth Attendants interviewed reported better outcomes, increased confidence, and a desire for more training. The cessation of Traditional Birth Attendants' training can present challenges, for although local health care units are discouraging the use of Traditional Birth Attendants, a significant number of women continue to utilise them regardless of their status of training.