Determinants of Timely Complication-Referral Practices among Traditional Birth Attendants in Selected Communities of Oyo State, Nigeria

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DOI: 10.21522/TIJPH.2013.08.02.Art023

Authors : Nnodimele O. Atulomah, Catherine O. Agbede, Adebayo M. Mustapha


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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