241481 Integration and control: The eradication of traditional birth attendants in the Philippines

Monday, October 31, 2011

Paul Kadetz, PhD, MSN, MPH , Department of International Development, University of Oxford, Oxford, United Kingdom
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. This was the earliest example of integration of heterodox health care practices into the formal health care system in the Philippines. 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. However, for the past three years the Department of Health of the Philippines has ceased these trainings and have ordered that all women are to be considered at risk during pregnancy and must be delivered in facility by skilled medical professionals.

This research examines the feasibility and potential outcomes of this policy to stop the practice of traditional birth attendants on local level health care and health care access. A qualitative design of data collection was utilised. Convenience samples (n =500) of community members, community leaders, health-care providers and key policy actors participated in semi-structured interviews and focus groups to assess the changes in community health-care systems and community health-care access in following this policy. Findings demonstrate that a majority of Filipino women prefer to deliver at home with a traditional birth attendant- regardless that they are no longer being trained or supplied with sterile birthing kits. Thereby, a potential for increased maternal and infant morbidity and mortality, especially in remote, poor and inaccessible areas where the implementation of this policy is least feasible is predicted from these findings.

Learning Areas:
Assessment of individual and community needs for health education
Diversity and culture
Public health or related public policy
Social and behavioral sciences
Systems thinking models (conceptual and theoretical models), applications related to public health

Learning Objectives:
Discuss the role of traditional birth attendants in the Philippines Analyze how the eradication of TBAs will affect local health care and maternal-child health Identify the complexity of the informal health care system and local population access

Keywords: Alternative Medicine/Therapies, Health Care Access

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am the sole investigator and author of this research
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.