Roles and Challenges of Traditional Birth Attendants in Prevention of Mother to Child Transmission of HIV in Nigeria - A Brief Review

Introduction: About 65% of deliveries in Nigeria (including HIV infected women) take place in settings like traditional birth attendants (TBAs). Though TBA involvement in PMTCT has some challenges, their success stories of increased HIV counseling and testing (HCT) uptake among pregnant women remains a reason for training, supervising and successfully integrating them into formal health centres and to reach the PMTCT target population. This is a brief review of roles and challenges of traditional birth attendants in Prevention of Mother to Child Transmission of HIV in Nigeria.

Methods: Keywords from objectives of review are MTCT, PMTCT and TBA which were used to search for related literatures through online libraries like national and international journals example medline and pubmed including google. About 62 related literatures/studies were initially generated and then narrowed down to 21 literatures which were selected because they met the inclusion criteria of less than 10 years and related to objective of review.

Findings: Because 65% of deliveries take place at non-formal settings like TBAs, they are being trained/engaged mainly by NGOs to be involved in PMTCT. Major success stories include; improved PMTCT knowledge and practices after training (p = 0.01) and increased HCT uptake at the TBAs (p = 0.001). Major challenges include low education level, reluctance to refer HIV positive patients in absence of incentives, poor reporting mechanism and poor-quality assessment/supervisions. National plans on accelerated PMTCT and elimination of MTCT currently advices that TBAs be integrated into formal health centres to further reach target population and cover the PMTCT gap in Nigeria.

Conclusion: TBAs have the potential of bridging the gap between formal PMTCT delivery points and the cultural communities where majority of the target population-pregnant women- live. Though challenges of TBA involvement are visible, support for training/retaining and quality assessment/supervision among TBAs could be the answer to the challenges of reaching the PMTCT target group and reaching the PMTCT target in Nigeria.