Success Stories
USAID-trained traditional birth attendants assist a woman to deliver quadruplets in Chicaca, Bailundo municipality of Huambo province
Photo: USAID/Angola
The 27-year civil war which ended six years ago had a negative impact on the delivery of all health services, including implementation of reproductive health services. Angola has one of the highest mortality rates in the world at 1500 per 100,000; infant mortality 150 per 1000 live births and tetanus is one of the main causes of neonatal tetanus. Tetanus coverage among the rural poor is low, about forty-seven (47 %) of women in the rural areas are vaccinated against tetanus. In Angola, qualified personnel assist less than half of all deliveries and a third of women do not see a doctor once during pregnancy. Sixteen percent (16%) of women are provided antenatal clinics by Traditional Birth Attendants and nineteen percentage (19%) are not provided at all. Sixty-five percent of the women either deliver their babies with the aid of Traditional Birth Attendants or that of family members. Coverage decreased both in urban and rural areas due to lack of accessibility and availability of the services. Traditional Birth Attendants are more frequently seen in the rural areas; they work as volunteers in their communities.
Huambo province in the 'Planalto' in Angola was heavily affected during the war.
USAID supported International Medical Corps in the training of Traditional Birth Attendants in the communities to assist births in the rural areas for women who otherwise would have no access to technical facility delivery services. More than 1752 TBAs were trained in a period of three years. The Traditional Birth Attendants were trained in basic female anatomy, importance of pre and post natal cares and how to provide it, clean delivery techniques, identification of obstetric risk cases and referral, family planning, immunization schedule, health education on health campaigns, HIV/AIDs and prevention.
In addition, the Traditional Birth Attendants are part of the village health committees and work in collaboration with the Ministry of Health through the health posts. Traditional Birth Attendants are health educators and are on duty 24 hours- a-day. They offer pre- and post-natal care education; teach the pregnant women the importance of tetanus vaccination in pregnancy, routine vaccination for the baby, pre and post natal clinic attendance, family planning, nutrition in pregnancy and general hygiene practices. The Traditional Birth Attendants deliver an average of 15 births a month. Obstetric emergencies are reduced because the Traditional Birth Attendants identify potential problems early. When complications arise during a delivery, the volunteers find transportation to take the woman to the municipal hospital. During the day, they remain at the health post's maternity unit, providing delivery services.
Christina Chica, a 31-year old mother of four from the Chicala commune, in Bailundo, delivered quadruplets with the help of Elisa Jekelepo a TBA trained in 2003 by International Medical Corps in collaboration with the Ministry of Health . She was transferred to the municipal hospital and later to the provincial hospital where there are facilities to attend to underweight babies.
USAID trained volunteer Traditional Birth Attendants help expecting mothers 24 hours-a-day in their communities
