Traditional birth attendants (8)

1 May, 2019

Dear Friends,

I am writing from India where I have worked for a long time on Traditional Birth Attendants and their role in maternity care. Caste issues and variations in traditions made it difficult to generalize about all Traditional Birth attendants. Global meta analysis of training of TBAs were I feel, unfair as they evaluated them on life saving skills when their training within the health system were mainly preventive ( e.g. 5 cleans under the CSSM initative led by Unicef in India) and not based on training for life-saving skills. Institutional delivery became India’s stated policy by 2005 with Skilled Birth Attendants excluding TBAs. By 2010/11 a majority of births in most of rural India were happening in institutions, however in some remote areas traditional birth attendants were still practicing.

From 2010-14 a group of researchers- calling ourselves Shepherds from a Jeeva (life) collective worked within a project administered by the Center for Women's Development Studies, New Delhi funded by the ICICI Foundation and the AYUSH Ministry Govt of India. This was a four state ethnographic research in India. Our report is submitted but has not yet been published.

You can see what we did at the website-

This is invaluable insight quickly being lost as universalization of "Institutional Birth" is India's national stated and practiced health policy. Also sadly none of this wisdom is currently incorporated into modern midwifery training of RNRMs.

Your comments are welcome.


Dr. Leila C. Varkey

Sr Adviser RMNCH Centre for Catalyzing Change (formerly CEDPA India)

C-1 Hauz Khas,

New Delhi 110016

011 47488888, Fax 4748888

HIFA Profile: Leila Varkey is a Senior Adviser in Reproductive, Maternal, Newborn and Child Health (RMNCH) at the Centre for Catalyzing Change in India.

Professional interests: Midwifery, Health Systems especially HRH, Quality of Care (QI and QA), India, and Scale up.

Email: lvarkey AT