









































Pa
ge

 
1



Pa
ge

 
1

American Journal of  Physical Education 
and Health Science (AJPEHS)

A Quantitative Assessment of  The Perception and The Roles of  Traditional Birth 
Attendants on Maternal Health Care among Women of  Reproductive Age in Ifedore 

Local Government Area of  Ondo State, Nigeria
Ogunmakinwa Florence Iyabo1*

Volume 1 Issue 2, Year 2023 
ISSN: 2992-9679 (Online)

DOI: https://doi.org/10.54536/ajpehs.v1i2.1823
https://journals.e-palli.com/home/index.php/ajpehs

Article Information ABSTRACT

Received: July 10, 2023

Accepted: August 12, 2023

Published: September 18, 2023

The fifth development goals (NDGs) aims at improving maternal health with the target of  
reducing maternal mortality ratio (MMR) by 75% between 1990 and 2015, but much has 
not been achieved in this area from then to the present time. It is in the light of  the above 
that this study quantitatively assessed the perception and roles of  traditional birth attendants 
(TBAs) on maternal health among women of  reproductive age in Ifedore local government 
area in ondo state. The study relied on the health belief  theoretical model to explain the 
social and psychological health behaviour of  women of  reproductive age with respect to 
patronage and knowledge of  the TBAs. A descriptive cross –sectional study design was 
used for the investigation. The sample consists of  three hundred and seventy-nine (379) 
respondents comprising 242 women of  reproductive age, 100 traditional birth attendants, 
20 medical and paramedical personnel randomly selected from local communities within 
Ifedore local government using a multistage sampling technique. Data were collected 
through structured questionnaire and the results were analysed using descriptive statistics. 
The findings revealed that majority of  the respondents have good perception of  the roles 
of  the TBAs in that area and that child-bearing women patronized them because they are 
cheaper than government’s hospitals services and closer to them than government-owned 
health facilities. The study concluded that the TBAs play vital roles in maternity health care 
delivery among women of  reproductive age in Ifedore local government area. It is,therefore, 
recommended that the government should as a matter of  necessity foster partnership with 
a view of  improving their skills to meet the global best practices. Also, health care services 
should be made affordable in public health institutions to encourage patronage by the rural 
and semi-urban dwellers.

Keywords

Birth Attendants, Health Care, 
Maternal Health, Reproductive 
Age, Respondents

INTRODUCTION
Traditional birth attendant (TBA) according to world 
Health Organization (WHO) is a person usually a 
woman who assists the mother at childbirth and who has 
initially acquired her skills delivering babies by herself  
or by working with other traditional birth attendants. 
Traditional birth attendants have been involving in 
national and international health programmes with a peak 
of  interventions in the 1970s and 1980s. The enthusiasm 
declined in the 1990s with a debate on their cost-
effectiveness and the missing impact of  TBAs’ training 
to reduce maternal mortality. By 1997, senior policy 
makers decided to shift priorities on the provision of  
skilled birth attendant (SBA) and subsequent withdrawal 
of  funding for TBAs’ training and exclusion of  TBAs’ 
in policies and programmes worldwide. Emphasis has 
been on the training of  TBAs’ since late 1950s and 
1960s to a recommendation that TBAs’ work should be 
integrated into the health system via training, supervision 
and technical support to today’s position of  promoting 
professionally skilled attendance at all births (9).
The fifth millennium development goal (MDG) aims to 
improve maternal health, with the targets of  reducing 
maternal mortality ratio (MMR) by 75% between 1990 
and 2015 and achieving universal access to reproductive 
health by 2015. An essential strategy for reducing the 
high maternal mortality ratio is to ensure that all births 

are managed by skilled health professionals.
In developing regions overall, the proportion of  deliveries 
attended by skilled health personnel  rose from 55% in 
1990 to 65% in 2009, despite dramatic progress in many 
regions, coverage remains low in sub-Saharan Africa and 
Southern Asia, where the majority of  maternal death 
occur(10). These two regions accounted for 85% of  the 
global maternal deaths, with sub-saharan Africa alone 
accounting for 56%. It was further noted that in many of  
these countries with large numbers of  maternal deaths, 
high quality maternity care is often unavailable and many 
deliveries are attended to by traditional birth attendants 
(TBAs), a relative or in some settings or no one, home 
births remain a strong preference and often is the only 
option in many areas, child bearing woman who does not 
give birth in a clinical setting relies upon TBA’s who may 
have received formal training or have gained experience 
by assisting neighbors, friends and family members to 
give birth (7,12). Many of  these TBAs have helped with 
the birth of  nearly entire generations in the villages, 
their social roles in the communities is recognized and 
respected and therefore, their attendance is highly valued.
In 2007, Federal Ministry of  Health formally approved 
and adopted the country’s reproductive health policy 
that stipulates that traditional birth attendants should 
only provide emotional support to women in labour 
but should not assist in delivery at home. This was in 

1 Department of  Public Health City University, Cambodia
* Corresponding author’s e-mail: ogunmakinwaflorence@yahoo.com



Pa
ge

 
2

https://journals.e-palli.com/home/index.php/ajpehs

Am. J. Phys. Educ. Health Sci. 1(2) 1-7, 2023

a bid to strengthening community based midwifery 
practice and helping the TBAs become advocates of  safe 
motherhood and to enhance maternal health. However, 
this has faced several challenges one of  them is being the 
poor relationship between TBAs and SBAs. To this end, 
TBAs still continue to practice home delivery and women 
continue seeking antenatal care (ANC), delivery and even 
postnatal care (PNC) from the TBAs.
Between 2009 and 2015, Ondo state in response to 
an 80% proportion of  TBAs related maternal deaths 
launched the “Agbebiye’’ programme to incorporate 
TBAs. The programme included free maternal and 
child health services in all public hospitals in ondo state 
establishing dedicated tertiary facilities for the care of  
pregnant women and children as well as collaborating 
with unskilled traditional and faith-based birth attendants 
to refer complicated labour case in their care to designated 
hospitals in exchange for cash incentives (20) 

Statement of  the Problem
The millennium development goal 5 set by United 
Nations is to improve maternal health by reducing the 
maternal mortality rate (MMR) by three-fourths by 2015. 
Nigeria was identified as one of  the countries that needed 
to achieve MDG 5 due to the high maternal mortality 
rates occurring in the country. The 2018 Nigerian national 
demographic and health survey (NDHS) reported the 
maternal mortality rate was 512 deaths per 100,000 live 
births. It has been observed over times that the activities 
of  TBAs have contributed in no small measure to ever 
increasing maternal mortality ratio index of  the country 
due to their unsafe practices which are marked by 
hemorrhages, infections,pre eclampsia, prolonged labour, 
use of  unsterilized equipment among others. In Ondo 
State Nigeria, the government in place between 2009 
and 2016 regulated the activities of  the TBAs in all the 
eighteen local government areas of  the state following 
their unwholesome practices with attendants increase 
in maternal mortality rate among pregnant women 
but the exit of  that government has brought back the 
unwholesome practices of  the TBAs in the state which 
has assumed a worrisome dimension. It is in the light of  
the above that this seminar paper aims at studying the 
perception and the role of  traditional birth attendants 
in maternal health care, particularly at Ifedore Local 
government area of  the state with high number of  
traditional birth attendants. This study is guided by the 
following research questions.

1. What is the perception of  the roles of  traditional 
birth attendants in maternal health care among women 
of  reproductive age in Ifedore local government area of  
ondo state?

2. What are the reasons for patronizing traditional birth 
attendants by women of  reproductive age in Ifedore local 
government area of  Ondo state?
     
General Objective
The general objective of  this study is to study the 

perception and the roles of  traditional birth attendants in 
maternal health care among women of  reproductive age 
in Ifedore local government area of  ondo state.

Specific Objectives
1. To assess the perception of  the roles of  traditional 

birth attendants in maternal health care among women 
of  reproductive age in Ifedore local government area of  
ondo state?.

2. To examine the reasons for patronizing traditional 
birth attendants by women of  reproductive age in Ifedore 
local government area of  Ondo state?

Significance of  the Study 
1. The findings of  the study will call for improvement 

in partnership among the government and the critical 
stakeholders in the health sector in order to improve 
maternal health among child bearing woman and.

2. The study will add to the body of  knowledge 
regarding traditional birth attendants 

LITERATURE REVIEW
Maternal Mortality in Nigeria
The maternal mortality ratio for Nigeria remains quite 
high at 814 per 100,000 live births according o 2016 world 
health statistics. Across the country, pregnant women 
and children under five years are generally charged fees 
when accessing health care services, despite the federal 
government’s declaration of  free health for pregnant 
women and children under five years of  age in 2005. 
According to Nigeria demographic Health survey 2013, 
over 60% of  pregnant women aged 15-49 deliver their 
babies at home without any antenatal care visits in rural 
areas, this value reaches 76.9%. The situation is critical in 
North east and north west regions of  Nigeria where over 
79% of  pregnant women age 15-49 deliver their babies at 
home. Over 60% of  pregnant women in Bayelsa, Plateau 
and Niger deliver at home rather than a health facility.
The distance of  pregnant women’s homes from a health 
facility and the cost of  health care are some of  the reason 
for not delivering at a health facility. The cost of  health 
care and perceived low quality of  care by the public have 
been argued to be the reason for the poor utilization of  
maternal and child health services in Nigeria. In addition 
health spending in Nigeria is low and this is responsible 
for the over-reliance on out of  pocket payment for health 
care services. According to Federal ministry of  health 
journal 2018.

The Traditional Birth Attendants (TBAs)
TBAs are defined by the WHO (1992) as a group of  
persons who assist mothers during childbirth and 
who initially acquired their skills by delivering babies 
themselves or through apprenticing with other TBAS. 
TBA’s have existed since time immemorial and fallen into 
the category of  informal healthcare providers who work 
locally in the rural areas. Women in rural areas usually 
use their services more than they use formal healthcare 



Pa
ge

 
3

https://journals.e-palli.com/home/index.php/ajpehs

Am. J. Phys. Educ. Health Sci. 1(2) 1-7, 2023

providers (18.20). TBA’s still exist despite the formal 
health care system because rural areas are characterized 
by poor infrastructure including impassable roads and ill-
equipped health facilities, among other things.
TBAs fall under the informal health system which is 
defined by four categories, training,  payment, registration 
and profession (21). The authors described TBAs as 
having received no formal training, although they may 
have gone through some level of  formal training such 
as apprenticeships, seminars and workshop funded by 
NGOs. stated that TBAs receive payment directly from 
the clients they serve (3,6). The existence of  TBAs in 
most villages is due to limited availability of  professional 
health care providers in rural area, leaving TBAs to fill the 
gap. There is a wide between formal and informal health 
care providers due to literacy levels (18). The TBAs are 
here to stay. They are part of  the community, socially, and 
culturally accepts and available whenever needed.
This explains how important TBAs are in their 
communities. The TBAs enjoy an important status in 
the community, which likely explains why policy make 
should consult with the TBAs to improve the health of  
the mothers in the rural areas (14).

The Roles of  TBAs
TBAs have existed for as long as women have given birth. 
The more they do has been tremendous and people in 
the rural areas value their services (13) Originally, TBAs 
had no form of  training but they still perform midwifery 
duties. Training began in the 1970s by the WHO and 
other funding organizations (3).
TBAs are a link between the rural people of  African 
and health care delivery (5, 15). It was further stated that 
TBAs have unique talents. They use inherited knowledge 
of  methods and practices that have evolved from the 
social, cultural and spiritual wealth of  the communities 
they serve. Despite TBAs being linked to high maternal 
mortality, they may also play a significant role in mitigating 
maternal mortality because they are first and often the 
only health care provider who can easily accessed in rural 
area, therefore, there is a need to involve them.
More than two thirds of  TBA in their study had no 
designated delivery rooms (5). They also did not consider 
any pregnant women to be in danger, therefore, they saw 
no need to refer them to the hospital for further check –
up. The author also stated that few of  the TBAs examined 
women during their frequencies. Despite this mother still 
used the services of  TBAs for many of  their deliveries.

Theoretical Framework
The study is anchored on the Health belief  theoretical 
model. According to Roserstock and Baker (1994), Health 
belief  model is a social and psychological health behavior 
change developed to explain and predict health related 
behavior with respect to acceptance of  intervention 
against disease or practice or otherwise. Therefore, the 
relevance of  this theory to this study lies on the fact that 
on average pregnant women will voluntary opt for health 

facility for her deliver only if  efficiency of  health care 
service the facility offers and the perceived severity of  
her case.

METHODOLOGY
The research design adopted for this study was descriptive 
research design. This method allow for collection of  data 
in quantitative manner.

Study Population
The study population comprise 232 women of  
reproductive age (15-49), 100 traditional birth attendants, 
15 medical and 17 paramedical personnel residing in 
Ifedore Local government area of  Ondo State,

Sample Size
To determine the sample size of  this study, Leiz Fisher’s 
formular was adopted. Below is the calculation:
n= Z2  (P [1-P])/d2

z= standardized normal (1.96)
p = Prevalence of  TBAs actions adopted from previous 
studies 
q= (1 - p)
d= is the level of  precision (0.05)
z= 1.96
n= (1.962 x 0.6 (1 – 0.6))/0.052

n= (1.96 x x 1.96 x 0.6 ( 0.4))/0.052

n= 0.92194/0.0025
n = 369
The, 369 respondents were considered as the sample 
size. A multistage sampling technique was adopted for 
the selection of  participant for the study. This type of  
sampling technique requires the researcher to choose 
his/her sample in stage until he/she gets the required 
sample (Asemali et al 2012). In using multistage sampling 
technique the ten (10) political wards in Ifedore local 
government area were first identified. They are Ero/
Ibuji/Mariiro, Igbaraoke I, IgbaraOke II, Ijare I, Ijare II, 
Ilara I, IlaraII, Ipogun/Ibule, Isarun/ Erigi, Ikota/ Irese 
ward.

Stage 1
This stage involves using stratified sampling technique to 
stratify the ten ward to 6 urban wards and 4 rural wards.

Stage 2
Here two (2) urban wards and 2 rural wards were selected 
through simple random sampling (balloting)

Stage 3
Communities in the 4 selected wards were listed out 
and two communities each selected randomly. Thus 
8 communities: 4 rural and 4 urban communities were 
selected in all. The 8 selected communities are: Aaye, 
Irese, Ayetoro, Uye, Igbeyin, Odofin, Asae and Iloro.
Participants in the selected communities, were assessed 
using structured questionnaire. The questionnaire 
instrument has three sections: Section A – Socio-



Pa
ge

 
4

https://journals.e-palli.com/home/index.php/ajpehs

Am. J. Phys. Educ. Health Sci. 1(2) 1-7, 2023

demography profile of  the respondents. section B- 
consist questions raised to assess the perceptions of  the 
respondents on the role of  Traditional birth attendant. 
Section C- question raised on ways of  improving 
activities of  traditional birth attendant in the area. The 
question consist of  both open and close ended question. 
The reliability of  the study instrument was tested through 
a pre-test conducted in one of  the selected wards 
(Ero/Ibuji) to ascertain the reliability of  the research 
instrument. A total of  20 respondents were drawn from 
the said ward for this purpose.

Data Presentation and Analysis
The data collected were analyzed using descriptive 
statistics such as frequency table, percentage, mean, etc. 
The table below provides the socio-demographic profile 
of  the respondent 

Section A: Socio--demographic profile of  the 
respondents.
Table 1 above present the analyses of  age of  respondent. 
From the table 206 (55.8%) respondents are between 

Table 1: Age of  respondents. 
Age group(yrs) Frequency Percentage %
15–19 10 2.7%
20–39 206 55.8%
40–49 59 15.98%
50–59 74 20.05%
60–69 20 5.42%
Total 369 100

Source: Field Survey 2022

the age bracket of  20-39yrs, 59 representing 15.98% 
are within the age range of  40-49yrs while 10(2.7%) fall 
within age 15-19yrs. This implies that the majority of  the 
respondents are within the active reproductive age.
Table 2 above presented the analysis of  the marital status 

Table 2: Marital status
Marital status Frequency Percentage %
Single 12 3.3%
Married 297 80.5%
Divorced 25 6.8%
Widowed 35 9.4%
Total 369 100

Source: Field survey 2022

Table 3: Religion of  respondent
Religion Frequency Percentage %
Christianity 300 81.3%
Islam 30 8.13%
Traditionalists 39 10.56%
Total 369 100

Source: Field survey 2022

Table 4: Educational status of  respondents  
Education status Frequency Percentage %
Graduate 
(MBBS,BSC,B.TECH, 
NSC,HND)

50 13.55%

OND,NCE Holders 100 27.10%
Secondary schools 
leavers

150 40.65%

Primary school 
certificate holders

40 10.8%

No formal education 29 7.9%
Total 369 100

Source: Field survey 2022

of  the respondents. The table revealed 297 (80.5%) 
respondents are married while 12(3.3%) are singles 
and 25(6.8%) of  them are divorcees, while 35(9.4% are 
widowed).
This implies that the majority of  the respondents are 
married women. The below table shows the analysis of  

Table 5: Respondents’ Views on Perception of  Roles of  Traditional Birth Attendants in Maternal Healthcare Among 
Women of  Reproductive Age in Ifedore Local Government Area.
Variable Yes% No%
Are TBAs services important in Ifedore Local government area 360(97.5%) 9(2.4%)
How many babies do you have
0 12(3.25%)
1 – 2 69(18.69%)

the religion status of  the respondents. From the table: the 
majority of  the respondents are Christians 300 (81.3%) 
while 30(8.13%) are of  Islamic faith and 39(10.56%) are 
traditional worshippers. It can be inferred from the table 
that Christians are in the majority.

The above table presented the analysis of  education 
attainment of  the respondent from the table 100 
representing 27.10% are graduates while 50 (13.55%) are 
secondary school levers, 150 (40.65%) are primary school 
leavers and 29(7.9%) are without formal education. This 
implies that respondents with secondary school certificate 
holders are in the majority.

Research Question 1 
What is the perception about the roles of  traditional 
birth attendants in maternal healthcare among women of  
reproductive age in Ifedore local government area?



Pa
ge

 
5

https://journals.e-palli.com/home/index.php/ajpehs

Am. J. Phys. Educ. Health Sci. 1(2) 1-7, 2023

3 – 5 268 (72.6%)
5 and above 20(5.42%)
Do TBAs take normal delivery? 300(81.3%) 69(18.69%)
Do they provide contractual services ? 300 (81.3%) 69(18.69%)
Do TBAs provide family planning services? 280(75.8%) 89(24%)
Do you believe complication can arise from the TBA care? 270 (73%) 99(26.8%)
Do TBAs provide special maternal birth to ward off  evil spirits? 300(81.3%) 69(18%)
Do TBAs provide concoction for mothers to drink to make the baby strong? 320(86.7%) 49(13.2%)

Source: Field survey 2022

Table 6: Reasons for using TBA’s Services among respondents   
Variable Yes% No%
Do you believe TBAs service are cheaper? 300(81.3%) 69(18.7%)
Do you believe TBAs services are culturally acceptable in your area? 297(80.5%) 72(19.5%)
Are TBAs centers closer to your house than hospital services? 340(92.1%) 29(7.9%)
Do you believe TBAs provide more compassionate care than orthodox health 
workers?

312(84.6%) 57(15.4%)

Do you think TBAs services should be banned? 20(5.4%) 349(94.6%)
Do you think TBAs service are effective but could be improved with some form 
of  training?

340(92.1%) 29(7.9%)

Are you satisfied with TBAs services? 320(86.7%) 49(13.3%)

The above table presents the analysis of  the perception 
of  the respondent on the role of  TBAs in Ifedore local 
government area. From the table 360 (97.5%) agreed 
that TBAs play important role in maternal health in 
Ifedore Local government while 9(2.4%) disagreed. 
300 representing 81.3% agreed that TBAs take normal 
delivery only 69(18.69%) disagreed. Similarly, 300 
(81.3%) agreed that they do conduct ante-natal care 
only 69(18.69%) disagreed. 280(75.8%) averred that 
TBAs provides family planning services while 89(24%) 
disagreed. however, 270(73%) agreed that simple form 
of  complications could set in during their operations 
while only 26.8% disagreed. In the same vein, 300 

(81.3%) agreed that TBAs usually provide their client 
with special maternal birth services to ward off  evil spirit 
only 69(18%) disagreed. 320(86.7%) equally were of  the 
view that TBA’s do provide concoctions for mothers to 
drink to make the baby strong only 15.2% disagreed. It 
can therefore be inferred from the above analysis that 
majority of  respondents have good perception of  the 
services of  the TBAs.

Research Question 2
What are the reasons for patronizing traditional birth 
attendants among women reproductive age in Ifedore 
local government area.

The above table presents the analysis of  the respondent’s 
reason for patronizing TBAs in their local government 
area. From the table 300 representing 81.3% of  
respondents agreed that TBAs services are cheaper 
only 69(18.7%) disagreed. Also, 297(80.5%) claimed 
TBAs services are culturally acceptable in their area only 
72(19.2%) of  them disagreed. On whether TBAs centers 
are closer to them than government hospitals, the majority 
340(92.1%) answered in the affirmative while only 
29(7.8%) did not agree. 312 (84.6%) respondents claimed 
TBAs service provide a more compassionate service than 
orthodox service only 57(15.4%) of  them disagreed. On 
whether TBAs service should be banned, the majority of  
the respondents 349(94.6%) disagreed with the assertion 
only 20(5.4%) agreed with respect to whether TBAs 
services are effective but could be improved upon with 
some form of  training 340(92.1%) agreed and 29(7.9)% 
disagreed. On whether the respondents are satisfied with 
the services of  the TBAs, majority of  them 320(86.7%) 
agreed that they are satisfied while only 49(13.3%) 

disagreed.
From the above analysis it can be inferred that majority 
of  the respondents have good reasons for patronizing the 
TBAs services.

RESULTS AND DISCUSSION 
The purpose of  this study is to assess the perception of  
the roles of  TBAs on maternal health among women 
of  reproductive age in Ifedore Local Government Area 
of  Ondo State. Findings from the study revealed that 
the majority of  the respondents are between the age 
range of  15-69 years. Also, the majority 360(93%) are 
married women.In respect to religion; Christians are in 
the majority (81.3%). The analysis of  the educational 
status of  the respondents revealed that respondents with 
secondary school certificates are in the majority. Their 
perception of  the roles of  TBAs in the area revealed 
that majority 297(80.5%) of  the respondents are of  the 
opinion that TBAs do take normal delivery only 18% 



Pa
ge

 
6

https://journals.e-palli.com/home/index.php/ajpehs

Am. J. Phys. Educ. Health Sci. 1(2) 1-7, 2023

disagreed. Similarly, 300 (81.3%) agreed that TBAs do 
conduct ante-natal care only 69(18%) disagreed. In the 
same vein, 300 representing (81.3%) do believe that 
TBAs usually provide their clients with special maternal 
birth to ward-off  evil spirit only 69(18%) disagreed. 
320(86.7%) of  the respondents claimed that TBAs do 
give concoctions to their clients (mothers) to drink to 
make their babies strong only 49(13.2%) were not of  the 
view. It can therefore be inferred from the above analysis 
that the majority of  respondents have a good perception 
of  the services of  the TBA’s
On the reasons why the respondents patronize the TBAs, 
analysis of  the reasons revealed that, the majority of  them 
300 (81.3%) claimed that TBAs services are cheaper than 
government hospital services 300(81.3%) only 69(18%) 
disagreed with the assertion. On whether TBAs services 
are culturally acceptable in the area, 297(80.5%) agreed 
with the assertion while only 18% disagreed. 340(92.1%) 
affirmed that TBAs centers are closer to their homes 
than government hospitals, only 29 (7.9%) were not of  
the view. On whether TBAs service should be banned, 
the majority of  the respondents 349(94.6%) disagreed 
with the assertion only 20(5.4%) agreed. The majority 
of  the respondents, equally affirmed that TBAs service 
are effective but should be improved with some forms 
of  training 340(92.1%) agreed while only 29(7.9%) of  
them disagreed with the assertion. On their level of  
satisfaction with the TBAs services, the majority of  them 
320 representing 86.7% claimed they are satisfied with the 
services of  TBAs in the area only 49(13.3%) disagreed. 
It can therefore be referred from the above analysis 
that majority of  the respondents have good reasons for 
patronizing the TBAs in the area. 
The findings of  this study are similar to the findings 
of  the study conducted by Ndambuki and Kambi 
(2007) in Migor County, Kenya where it was concluded 
that activities of  the TBAs are good but needed to be 
pepped up with modern training. However, the findings 
contradicted the findings of  the study carried out 
by Chelo, Zulu and Nzala (2016) in rural district of  
Kazungula in Zambia where they concluded that the 
majority of  the participants enlisted in the study were of  
the opinion that services of  TBA’s in the area are below 
standard and should be banned. 
However, the future research can provide information 
on the influence of  Traditional Birth attendants (TBAs) 
activities on maternal mortality which was not investigated 
by this study.

CONCLUSION
The study concluded that the majority of  women of  
reproductive age in Ifedore Local Government Area 
of  Ondo State have a good perception of  the services 
of  traditional birth attendants. However, there is a 
necessity for TBAs knowledge and skills to be improved 
with adequate training through a sustained partnership 
between the TBAs and the orthodox health system. 
Therefore, with due juxtaposition to the locations of  

the previous studies with this study, the following that 
will foster a health collaboration between providers of  
orthodox and traditional maternity services which will 
translate into improved maternal and neonatal health 
outcomes in relevant settings are hereby recommended. 

RECOMMENDATIONS
1. Government should as a matter of  necessity foster 

partnership between TBAs and orthodox medical 
practitioners with a view to have robust health care 
services. This is because of  the strategic position occupied 
by the TBAs in most rural areas.

2. Government should embark on training and 
retraining of  the TBAs to asquint them with the modern 
skills in the field of  midwifery

3. Government should constitute enforcement team 
to monitor the activities of  the TBA’s both nationally 
and locally with a view to make them comply with the 
acceptable standard as laid down by the regulations 

4. Providing adequate training to the TBA’s by 
government and other stakeholders will go along way in 
helping them know their scope and limitation and possibly 
refer mothers and their infants for immunization, family 
planning, and emergency services.

5. Policies should be enacted by the government 
that will incorporate an ecological system view which 
will acknowledge and recognize the contributions of  
TBAs and socio-historical factors that encourage their 
utilization.

6. Stakeholders should improve on the role of  men 
in pregnancy and postpartum period by providing 
education, incentives and support for men that can be 
instrumental in reducing maternal mortality and thus 
increase health care usage. This is because if  men gave 
their wives more permission to go to a health care center, 
healthcare utilization will increase.

7. Government should make the health care services 
affordable so as to increase the patronage of  government 
health institutions as the present public health care 
services are expensive to access by the pregnant women

8. Governments should establish many more hospitals 
in the rural and semi-urban communities

REFERENCES
Abiodun, O., Sotunsa, J.,Olu- Abiodun, O., Ani, F., 

Taiwo, A. and Taiwo, O. (2015).The effect of  
training and traditional births attendants :PMTCT 
related knowledge   and care  practises in Nigeria. 
Journal of  clinical research, 6(9), 498. https://doi.
org/10.4172|2155-6113.1000498

Balogun, M. & Odeyemi, K. (2010). Knowledge 
and practice of  prevention of  mother –to- child 
transmission of  HIV among traditional births 
attendants of  Lagos State, Nigeria Pan Africa Medical 
Journal. 5(7). www.acbi.num.nih.gov.

Banda, E. C. (2014). Stakeholders’ perceptions of  
changing the role of  traditional birth attendants  in 
the rural areas of  central wets zone, Malawi:amixed 



Pa
ge

 
7

https://journals.e-palli.com/home/index.php/ajpehs

Am. J. Phys. Educ. Health Sci. 1(2) 1-7, 2023

method study. Electronic Theses and Dissertations (ETD). 
wiredspace.wits.ac.za

Byrne, A. and Morgan, A (2011). How the integration 
of  traditional births attendants with formal health 
system can increase skill births attendants International 
journal of  gynaecology and obstetrics, 115(2) , 127- 134. 
https://doi.org/10: 1016|j.ijgo.2011 06.019

Cheelo, C., Zulu. J. M. and Nzala, S. C. (2016). Banning 
traditional birth attendants form conducting deliveries: 
experiences and effects of  the ban in a rural district 
of   Kazungula In Zambia.Journal summaries in internal 
medicine 16,323. www. Ndlinx.com

Chi, P. C and Urdal, H. (2018). The evolving role 
of  traditional births attendantsin maternal 
health in post conflict Africa  a qualitative study 
of  Burundi andnorthern Uganda. SAGE open 
medicine, 19(6), 2050312117753631. https://doi.
org/10.1177|205031211775363|.

Dorwie, F. M and Pacquicio, D. F.(2014). Practices 
of  traditional birth attendants in sierraleoneand 
perceptions by mothers and health professionals 
familiar with their care.J.  Transcult nurs. 25.(1), 34-41 
https://doi.org/10-1177|1043659613303876

Imoge, A. O., Agwubike, E. O. and Aluko, 
K.(2022). Assessing the role oftraditional births 
attendants(TBAs)in health care delivery in Edo state 
Nigeria. African journal of  reproductive health, 6(2), 34-
100 https://doi.org/10.2307|3583135

Iwu A. C.,Uwakwe, K., Oluoha, U., Duru, C and 
Nwaigbo, E. (2021).EmpoweringTraditional births 
and attendance as agents ofmaternal and neonatal 
immunization uptake in Nigeria: arepeated measure 
design. BMD Public Health, 21, 287. https://doi.
org/10.10011186|s12889- 02110311.

Jebet J. Gitonga, M., Mutual M. E,Mukuu, J. S., 
Ndanibuki, J. and Koima J.W(2017).Perception about 
traditional birth attendants by men and women of  
reproductive age in rural megor, Kenya. International 
journal of  Africa nursing sciences, 7(02) , 55-61. https://
doi.org/10.1016|J.ijons.2017.07.002.

Kabayambi, J. (2013). Revisiting policies on traditional 
birth attendants. News Vision. www. New vision.com 
|new vision|news |1319203 |

Kayombo, J. E. (2013). Impact of  training of   birth 
attendants on maternal lmortality and morbidity in 
sub-Saharan African countless, Tanzanian journal of  
health research, 15(2),1-11. http://dx.org//10.431/
thrb.v15i2.7.www.ajol.com.

Mimiko, O. (2012). Maternal health in Nigeria ondo state 
abiye safe motherhood Model(examine the ondo 
state abiymodel). https://csis.org/files/attachment/

es130116-maternal-health-in-nigeria-allsides-o.pdf
Ofili, A. N. and Okojie, O. H. (2005). Assessment of  

the role of  traditional birth attendant in maternal 
health care in oredolocal government area Edo State, 
Nigeria. Journal of  community medicine and primary health 
care, 17(1), 55-60.

Ojwee, D. (2012). Gulu pleads for birth attendants.
Newvision.www.newvision.co.ng/new-bir th-
attendants.1304569/gulu – pleads – for- birth –Attendants. 
https://doi.org/10.1177/1043659613303876/ 
Pubmed.ncbi.nim.nih.gov 

Ohaya, M. and Murphy – lawless, J. (2017). Unilateral 
collaboration:The practices and understanding of  
traditional birth  attendant in south eastern  Nigeria. 
Journal of  woman birth, (30)(a), 165-171. https://doi.
org/10. 1016/j. Womb. (2016)11.004

Oke, R. (2009). Iya –Agbebi traditional birth attendants 
in Yoruba settingand the issues of  HIV and AIDS.
Laminarinterdisciplinary research and scholarly Journal, 
2(1),135-143. E-  Journals .ph.

Oshonwoh, F. E., Nwkanko, G. C. and Ekiyo, C. P. 
(2014). Traditional birthattendants and woman health 
practices. A case study of  Patani in southern Nigeria. 
Journal of  public healthepidemidogy, 6(8), 252-261. 
https://doi.org/10.5897/JPHE 2013-0634 https: // 
www. academic journals.org.jphe

Oyeneyin. L., Vanden Akker, T., Durojaye, O., Obaado. O., 
Akanbiemu, F., Olagbuji,  Y., Aledemiyi. I., Oyeneyin. 
M. and Aledenola, O. (2019).Confidentialenquires 
into mater death in ondo state, Nigeria –a 
comparativeanalysis. BMC pregnancy and childbirth, 
19,514. https://doi.org/10.1186/s/2884-019-5659-y

Oyeniyin. L ., Osunmakinwa, O. and Olugbogi, Y.(2021). 
Incorporating traditional birth attendants into the 
mainstream maternal health system in Nigerian- 
evaluation of  the ondo state Agbebiye program. 
African journal ofreproductive health, 25(4), 82-88.https://
doi.org/10.29063/ajrh2021/v25i4.9.www.ayrh.info

Sibley, L. M., Sipe, T. A.and Barry, D. (2012). Traditional 
birth attendants training for improving health 
behaviours and pregnancy outcomes. Cochrane Database 
systemRev.15, 8(8). https://doi.org/10.1002/1465185.
cd005460. ncb.n/m.Nih.gov.

World health organisation (2004). Marking pregnancy safer: 
the criticalrole of  the skilled birth attendants. A join 
statement by WHO,ICM andFIGO. https://WHOicbdoc.
Who.Int//publications/2004/9241591692

World health organisation. (2019). Skilled attendants at 
birth globalhealth. Observatory  (GHO) data.http:www.
who.int/gho/maternal-health/skilled-care/skilled-
birth –attendants–tests /en   


