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Background to the study 
Every year, approximately 600,000 women die of pregnancy-related causes (WHO, 2010). Ninety-eight percent of these deaths occur in developing countries, and for every woman who dies, at least 20 others suffer injuries and, often, permanent disability (WHO, 2010). Maternal mortality rate in Nigeria is estimated to be approximately 630 deaths/100,000 live birth in 2010, and the main causes identified include: hemorrhage, infection, obstructed labour and hypertension (WHO, 2012). Nigeria accounts for 40% of the global burden of vesico vaginal fistula, which translates to an estimated 800,000 women suffering from conditions arising from prolonged labour and complicated deliveries. One of the major factors responsible for the identified causes of rising maternal and infant morbidity and mortality is lack of skilled birth attendance at birth (WHO, 2008). In developing Countries, specifically in Sub Saharan Countries many women do not have access to skilled birth attendance during child birth. According to the Nigeria demographic and health survey (2009), between 2003 and 2008, only 46% of women living in rural areas received antenatal care from skilled provider (i.e doctor, nurse/midwife, auxiliary nurse/midwife), 28% of births were assisted by a skilled provider and 25% of deliveries took place in health facility (NDHS, 2009). An eastern Nigeria study also showed that although 93% of the rural women registered for pre-natal care, 49% delivered at home under the care of the Traditional Birth Attendants (TBAs) (Imogie, 2012). In Nigeria, the choice to deliver outside hospital settings could be motivated by varying factors such as economic, social, physical, cultural or institutional (Ahmed, Odunukwe, & Akinwale, 2009). Outside the hospital setting, women can be assisted by an attendant who may be unqualified. These attendants could be a TBA, village midwife, members of the family or neighbour (Ahmed et al, 2009). A TBAs as defined by the World Health Organization (WHO) is a person who assists members during childbirth and acquired her skills by delivering babies herself or through apprenticeship to other TBAs (WHO, 2008). Throughout history, TBAs have been the main human resources for women during childbirth. Their role varies across cultures and times, but even today, they attend to the majority of deliveries in rural areas of developing countries. Secondary analysis of the 2003 to 2008 Demographic Health Survey (2009) found that TBAs (Trained and untrained) assisted 24% of 200,633 live births (ranging from less than 1% to 66%) in 44 developing countries representing five regions of the world. TBAs attend to a number of deliveries especially where modern health services are unavailable or inadequate (Hussien & Mpembeni, 2009). In Nigeria it is estimated that between 60% and 80% of all deliveries occur outside modern health facilities with significant proportion of these attended to by TBAs (WHO, 2008). Typically, TBAs attract clients by reputation and word-of-mouth and usually they receive remuneration for the services rendered. Rural dwellers prefer to use the services of TBAs as compared to their urban counterparts. Reasons for the preference include TBAs availability, accessibility, cheap services and rural dwellers faith in the efficacy of their services (Bello et al, 2009). Despite the high patronage of TBAs, their practices during childbirth have been found to adversely affect the health of the mother and the fetus (Hussein & Mpembeni, 2009). There is need for improvement through a more holistic training programme including monitoring and supervision. Health education, training and other strategies aimed at changing the attitude of TBAs towards utilization of sterile procedures, immunization services and prompt referrals of complicated obstetric clients to where modern healthcare facilities exist are recommended (Rowen, Prata & Passaw, 2009). The objective of the training of TBAs is to ensure that they have gained competencies in information, certain skills and procedures necessary for the safety of the mother and the baby and most importantly recognizing high risk pregnancies and complications during labour and referring them promptly to the modern health facilities (Sibley Sipe, Brown & MCnatt, 2010).

Project detailsContents
Number of Pages124 pages
Chapter one Introduction
Chapter two Literature review
Chapter three  methodology
Chapter  four  Data analysis
Chapter  five Summary,discussion & recommendations
Chapter summary1 to 5 chapters
Available documentPDF and MS-word format


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