Handling postpartum haemorrhage- obstetrics between tradition and modernity in post-war Sierra Leone.

Abstract:

OBJECTIVES:How traditional birth attendants (TBAs) in post-war Sierra Leone explain, handle and prevent postpartum haemorrhage (PPH) and their potential role in a better management of PPH to reduce maternal mortality in this low resource setting. METHODS:Semi-quantitative interviews about knowledge and measures in PPH and participant observation with 140 Sierra Leonean birth attendants, divided in three groups: (A) TBAs who never attended any official training course (n = 82); (B) TBAs who attended at least one official training course (n = 48); and (C) officially trained birth attendants (n = 10). RESULTS:There are several observable gaps in the knowledge of TBAs about PPH compared to modern obstetrics, however similar procedures exist. Herbal medicine is applied; metaphysical convictions about PPH remain present. Training courses show an impact. Officially trained birth attendants demonstrate knowledge deficiencies and lack resources and infrastructure to manage PPH adequately. CONCLUSIONS:Morbidity and mortality of PPH in Sierra Leone is related to several factors and not solely to the ignorance of TBAs. TBAs still play an important role for many women there. Hence improvement of the formal health sector should be combined with life-saving programmes integrating TBAs in the care for the pregnant, delivering and breastfeeding mothers.

journal_name

Trop Doct

journal_title

Tropical doctor

authors

Bräuer MD,Antón J,George PM,Kuntner L,Wacker J

doi

10.1177/0049475514557579

subject

Has Abstract

pub_date

2015-04-01 00:00:00

pages

105-13

issue

2

eissn

0049-4755

issn

1758-1133

pii

0049475514557579

journal_volume

45

pub_type

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