Traditional birth attendants (3)

10 April, 2019

To ban non skilled persons who have been taking normal deliveries is ill-advised. To mandate only skilled persons to take deliveries in a world with severe shortage of human resource in health, puts pregnant women at more risk during delivery.

It is better to Task shift activities in child birth but ensure that the TBAs are trained, equipped with clean equipment and then monitor their practice. That in our view is the rational pragmatic policy with less risk than banning them. They will not disappear because not only do the pregnant women trust them, which is why they go to them, even when there are skilled practitioners in the same locality. Until there are sufficient skilled personnel to go round, a planned and structured engagement of TBAs makes better sense especially in LMICs.

Joseph Ana.


@Health Resources International (HRI) WA.

National Implementing Organisation: 12-Pillar Clinical Governance

National Implementing Organisation: PACK Nigeria Programme for PHC

Publisher: Medical and Health Journals; Books and Periodicals.

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HIFA profile: Joseph Ana is the Lead Consultant and Trainer at the Africa Centre for Clinical Governance Research and Patient Safety in Calabar, Nigeria. In 2015 he won the NMA Award of Excellence for establishing 12-Pillar Clinical Governance, Quality and Safety initiative in Nigeria. He has been the pioneer Chairman of the Nigerian Medical Association (NMA) National Committee on Clinical Governance and Research since 2012. He is also Chairman of the Quality & Performance subcommittee of the Technical Working Group for the implementation of the Nigeria Health Act. He is a pioneer Trustee-Director of the NMF (Nigerian Medical Forum) which took the BMJ to West Africa in 1995. He is particularly interested in strengthening health systems for quality and safety in LMICs. He has written Five books on the 12-Pillar Clinical Governance for LMICs, including a TOOLS for Implementation. He established the Department of Clinical Governance, Servicom & e-health in the Cross River State Ministry of Health, Nigeria in 2007. Website: Joseph is a member of the HIFA Steering Group: