Experts push TBA integration to improve maternal care

Health experts have called for stronger collaboration between traditional birth attendants (TBAs) and the formal healthcare system to improve maternal healthcare delivery in rural communities across Nigeria.
They made the call in interviews on Tuesday in Niger, emphasising the need to reduce preventable maternal and newborn deaths nationwide.
A gynaecologist at Charles Healthcare Hospital, Suleja, Charles Umeh, said TBAs should be transformed into community health allies rather than being sidelined in maternal healthcare delivery systems.
He said that while TBAs could support maternal care, they could not replace skilled health professionals, especially in managing emergencies such as haemorrhage, obstructed labour and other childbirth complications.
“I have attended to patients with serious complications during childbirth. I usually liaise with some of these attendants so we can help patients before situations worsen,” Mr Umeh said.
Mr Umeh added that his ability to communicate in multiple languages had helped him build trust and cooperation with TBAs, improving referrals and emergency responses during complicated deliveries in rural communities.
“Some traditional birth attendants are respected in their communities and women trust them, but childbirth is unpredictable,” he said, warning about risks linked to unassisted deliveries.
A traditional birth attendant in Suleja known as “Iya Agbebi,” Wuraola Adebisi, said women preferred TBAs because they understood local traditions and communicated in languages familiar to rural clients.
“Women feel comfortable with us because we understand their traditions and speak their language. They come to us not just for delivery, but for support throughout pregnancy,” she said.
One of her clients, Maimuna Suleiman, said her family relied on home deliveries due to financial constraints and cultural beliefs, adding that she had experienced no complications across four births.
A civil servant, Aliyu Yusuf, said integrating TBAs into the health system through training and referral networks could reduce maternal and infant deaths with continued reliance on them in rural communities.
He said that TBAs often remained the first point of contact for pregnant women in underserved areas, where access to hospitals and skilled birth attendants remained limited.
A nurse, Joy Sunday, emphasised that sustained investment in primary healthcare, infrastructure and community education was essential to improving maternal health outcomes nationwide.
Nigeria’s Federal Ministry of Health, alongside partners such as the World Health Organisation (WHO) and United Nations Children’s Fund, continues to support training programmes for TBAs in basic maternal care.
According to the Federal Ministry of Health, maternal deaths in health facilities dropped from 904 cases in 2024 to 460 in 2025 due to improved skilled maternity care and emergency obstetric services.
The WHO maintained that expanding access to skilled birth attendance, antenatal care, emergency obstetric services and postnatal care remains critical to reducing preventable maternal and newborn deaths globally.
(NAN)
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