The Effects of Traditional Birth Attendants on Maternal and Neonatal Outcomes

Abstract

Traditional Birth Attendants (TBAs) play a crucial role in maternal and neonatal healthcare, particularly in resource-limited settings. This systematic review examines the impact of TBAs on maternal and neonatal outcomes across Nigeria, analyzing 13 studies with varying methodologies, sample sizes, and geographic coverage. Findings indicate that TBAs improve access to maternal healthcare, especially in rural and underserved areas, with utilization rates ranging from 44.03% to 55.97% in different communities. However, the effectiveness of TBAs is limited by inadequate training, poor recognition of obstetric complications, and inconsistent referral systems, contributing to increased maternal mortality in some regions. Studies highlight a significant relationship between TBAs and maternal health outcomes, with community-based interventions reducing maternal mortality in urban slums of Lagos. Health education interventions significantly improved antenatal care attendance and skilled delivery rates (p < 0.05). Despite these positive contributions, methodological limitations, including heterogeneity in study designs and inconsistent outcome measures, hinder definitive conclusions. The review emphasizes the need for standardized research methodologies, including randomized controlled trials, to establish causal relationships. Policy recommendations include strengthening TBAs’ integration into formal healthcare systems, expanding structured training programs, and improving referral mechanisms to skilled birth attendants. Addressing socioeconomic and infrastructural barriers, particularly in Northern and rural Nigeria, is crucial for optimizing maternal and neonatal health outcomes. This review underscores the potential of TBAs in bridging healthcare gaps while advocating for evidence-based interventions to enhance their effectiveness. Future studies should focus on long-term impacts and sustainable models for TBA collaboration with formal health systems.