Traditional birth attendants’ contribution to healthcare should not be downplayed

Traditional birth attendants often go unrecognised, despite the critical service they provide in many communities, especially where there is no hospital nearby.

Last week the inaugural Traditional Birth Attendants Conference, organised by the Department of Science and Technology (DST) and the University of KwaZulu-Natal’s Centre in Indigenous Knowledge Systems, was held in Durban.

Held on 5 and 6 June 2019, the gathering was a response to traditional birth attendants’ demand to be recognised by government as champions of indigenous knowledge, as part of efforts to restore dignity to African practices.

Addressing the event, the Acting Head of the National Advisory Council on Innovation, Dr Mlungisi Cele, said that the South African Government had declared its intention to affirm indigenous knowledge, most recently through the Protection, Promotion, Development and Management of Indigenous Knowledge Act (IK Act), which has been passed by both the National Assembly and the National Council of Provinces, and is awaiting signature by the President. The legislation provides for the recognition of the competencies of IK holders and practitioners such as traditional birth attendants (TBA).

Kebilediwang Manyeke from the Northern Cape has been practicing as a TBA for the past 46 years. She explained the significant role these women play.

“The area I come from has one clinic, which does not operate over weekends or at night. I have safely delivered many babies in my bedroom, including breech babies, but despite my extensive experience, doctors and nurses question my ability to do the work because I do not have a certificate to prove my competence,” lamented Ms Manyeke.

Her sentiments were echoed by fellow traditional birth attendant, Nosipho Mabandla of KwaLanga in the Western Cape, who pleaded with universities to empower TBAs with further training and some form of certification.

“Ambulances do not come to certain areas because the staff fear for their own safety, leaving pregnant women and babies in danger. TBAs are the only option in situations like these,” she said.

“Ongoing shortages of medical staff remain a challenge in rural areas,” said Olive Tengera of the School of Nursing and Midwifery at the University of Rwanda.

Ms Tengera sees the use of skilled TBAs as a vital part of reducing maternal mortality in developing countries. She proposed many interventions, such as public health system mentorship and supervision of TBAs in partnership with other sectors. These would allow for distance learning and create a space in which TBAs could share best practice and receive regular training.

“At this stage, the disconnect between TBAs and the formal health system hampers access to maternal health services and the identification of TBAs for training,” she concluded.

The conference supported the establishment of mechanisms for the recognition of prior learning and accreditation of knowledge holders as espoused in the IK Act.

Dr Yonah Seleti, Chief Director: Science Missions at the DST, said that recognising the knowledge and experience of indigenous knowledge holders will enrich the country’s knowledge systems.

The Department has embarked on an intensive programme focusing on the development of competency-based norms and standards in the domain of African traditional medicine, starting with four categories of indigenous knowledge practitioners, namely, sangomas, inyangas, traditional birth attendants and traditional surgeons.

The programme, carried out in partnership with North-West University, the South African Qualifications Authority and the University of KwaZulu-Natal, facilitates the documentation of cultural values and competencies towards a system that will recognise and validate informal and non-formal learning.

Dr Seleti said that since 2018 the DST had been undertaking a process to ensure that TBAs were recognised and respected as professionals through official certification.

The challenges raised during the conference were noted, and the DST plans to discuss them with other departments involved.

Source: Department: Science and Technology

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