Traditional Birth Attendants in the Sengerema District Northwest of Tanzania: Whom they Serve and why their Delivery Practices Matter

Introduction: Reduction of maternal deaths due to preventable and manageable causes remains a public health challenge in Sub-Saharan Africa. In Northwest Tanzania, the emergency obstetric care services that are available are relatively poor and home delivery is commonly practiced. The aim of this study was to investigate the characteristics of women who delivered at home and delivery practices of Traditional Birth Attendants (TBAs) in the Sengerema District Northwest of Tanzania. Methods: This descriptive cross sectional study recruited postpartum women who delivered at home, and TBAs from Sengerema District. Fifty TBAs identified by the community health workers and 160 postpartum women participated in face-to-face interviews in their homes. Results: The majority of participants delivered their first born at home and displayed limited knowledge on pregnancy danger signs. Home delivery was considered feasible and acceptable by participants due to the accessibility, affordability and availability of TBAs services in their communities. None of the TBAs had formal midwifery training and their use of protective gear was low (32%) with majority of TBAs assisting delivery with bare hands. The use of herbal medicines and massaging were frequently reported by the TBAs to manage severe bleeding, prolonged or obstructed labour, and retained placenta. Conclusion: Poor knowledge of the danger signs that are indicative of potential birth complications among women and accessibility to and affordability of health care services could be associated with home delivery practice. TBAs had no formal training in midwifery and their practices could place women and their infants at risk for complications during and following delivery.