Determinants of Timely Complication-Referral Practices among Traditional Birth Attendants in Selected Communities of Oyo State, Nigeria
Background Prevalence of poor pregnancy outcomes
with complications and maternal mortality account for 75% of maternal mortality
resulting from the practice of traditional birth attendants (TBAs) who are not
skilled sufficiently to detect high-risk pregnancies and birth complications
early for referrals. This study was undertaken to understand the dynamics
involved with timely complication-referral practices among TBAs in selected communities
in Oyo State, Nigeria.
Methodology This cross-sectional survey
utilized interviewer-administered 58-item validated questionnaire for data
collection from 210 consenting TBAs recruited by
multistage sampling technique across three senatorial districts of the State.
Knowledge, perception of seriousness, susceptibility of pregnancy complications,
perceived benefits of referral, Self-efficacy, attitudinal dispositions, reinforcing
and enabling factors, and referral-practices were measured
on 16-, 15-, 12-, 15-, 9-, 12- 12-, 15- and 18-point reference scales
respectively. Data analysis reported means and standard deviations and test of
associations to determine predictors of the outcome variable. All statistical
tests were at 5% level of significance.
Results Study showed that 80% of respondents
acquired their skills through apprenticeship training while mean scores for knowledge
(4.1±0.25), perceived seriousness (4.34±0.30), perceived susceptibility
(6.92±0.22), perceived benefits (9.42±0.25), self-efficacy (5.68±0.26),
attitudinal dispositions (4.85±0.29), reinforcing (3.16±0.40) and enabling
factors (3.86±0.18) and timely complication-referral practices (7.75±027) were
all not satisfactory. Enabling factors most significantly predicted referral
practices (R= 0.882; r2=0.778; p<0.001).
Conclusion All variables scores were poor. Enabling
factors defining infrastructural resources and training most significantly
predicted referral practices. The study recommends constant capacity-building
to improve skills of TBAs to recognize high-risk pregnancy and initiate early referrals.
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