Birth attendants

Traditional Birth Attendants are pregnancy and child birth care providers that have been well-rooted in our society, well before the advent of modern medical practices. Going by their origin and orientation, they were not formally educated, as they get their knowledge through apprenticeship and oral teaching. Usually, they are seen in remote and other medically underserved areas, where their services are welcome, albeit despite the risks. It should be noted here that orthodox health practitioners are particularly against Traditional Birth Attendants, not necessarily because of competition or neo-colonialism as many want to claim, but according to former Director of Nursing Services in the Lagos State Ministry Of Health, Mrs. Olubumi A. Raheem, because of their weaknesses, which “lie in harmful traditional practices, which may have harmful effects for her clients; unhygienic practices and inexistence of the referral system.”

Role of traditional birth attendants in nigeria
Government however recognises their relevance nevertheless, especially in the remote areas where they are top choices and sometimes, the only available choice, hence the decision to train them in government hospitals and imbue them with the power of referral, such that they are able to refer patients who need special medical attention. They now also get certifications, licensure and registration.
In a Lagos State Maternal and Child Mortality Reduction (MCRC) Program released last year, Nigeria is one of the 187 countries that signed the Millennium Declaration in 2000 with the aim of reducing the 8 identified goals/targets substantially by 2015.  Notably, reducing maternal mortality rates is one of the goals.

However, the country, as at 2015 still has one of the highest maternal mortality rates in the world, which varies between 800 to 1,000 births based on the geographical location. In 2008, the figure, though slightly better than the national average of 650/100,000 live births (NDSHS 2008), was still unacceptably high.
The figures also show that two decades after various Safe Motherhood initiatives since its launch in Nairobi in 1987, Nigeria has failed to make any remarkable impact on the maternal health indices.
This may therefore be one of the reasons a state like Lagos is relaxing its noose on Traditional Birth Attendants, reputed to be one of the major factors responsible for the poor indices.
Investigations also confirm that more Nigerians prefer the Traditional Birth Attendants to the orthodox health facilities. In 2013, 154,304 attended antenatal at the Primary health care (PHC) centres, while only 16,699 delivered. The same trend continued in 2014, where between January and August, 121,451 attended PHCs for antenatal, but only 13,000 delivered there.
Coordinator of Reproductive Health, in the ministry, Taiwo Johnson also said that the state Ministry of Health reviewed maternal death records from secondary facilities in certain areas and uncovered the causes of maternal deaths to find solutions.
“In March, we went to Ajeromi-Ifelodun because we noticed a high incidence of maternal deaths in cases referred to our facilities from quacks. Then, we came to Epe, where records showed that a number of maternal deaths can be traced to TBA in nigeria,” she stated.