| Summary: | A descriptive quantitative study was undertaken in the Leribe and Butha-buthe
northern districts of Lesotho. Thirty-six trained, twenty-four untrained TBAs and
nine nurses involved in training TBAs were recruited.
In line with research by Clarke and Lephoto (1989:3) the TBAs were elderly
females who had children of their own. In contrast with the MOH (1993: 10)
where TBAs were found to be illiterate, most (93%) of the TBAs in this study had
at least a primary education.
The art of primary midwifery was learned through assisting with a delivery and
being taught by mothers or mothers-in-law. The public health nurses conduct
formal training ofTBAs in Lesotho over a period of two weeks, where subjects
like ante-natal care, delivery of the baby and post- natal care are addressed.
The majority (78.8%) provide antenatal care at their homes or the home of the
mother. This includes palpation, history taking, and abdominal massage and
health education. An important role is identifying women at risk. During
labour the progress of labour is monitored and care is given to the mother and
baby post-natally. Trained TBAs could identify women at risk more readily than
untrained TBAs. Cases referred most frequently were prolonged labour and
retained placenta. Trained TBAs practiced hygiene more often and gave less
herbs than untrained TBAs.
The health care system is providing support to the TBAs through training and
supervision, but was found to be inadequate. Community leaders are involved in
the selection of TBAs for training. Regular meetings are held with the TB As to
discuss problems. Communication is one of the problems the TB As have to face,
because of the long distances from health care centres. A lack of infrastructure
and supplies is also of concern.
It can be concluded that TBAs play an important role in maternal health care in
Lesotho and are supported to a lesser degree by the health care system, which
causes problems for the TBAs in their practices.
It is recommended that the ministry of health becomes more aware of the need for
training TBAs and that a programme for training should be more appropriate,
taking cultural practices into account. === Advanced Nursing Science === D.Lit. et Phil.
|
|---|
