Effect of Training on Knowledge and Practices of Traditional Birth Attendants for the Prevention of Malaria in Pregnancy in Nigeria

Abstract

Background: Approximately 25 million women become pregnant each year in malaria-endemic areas in Africa. More than 60% of these women visit the traditional birth attendants (TBAs) for their antenatal care. This study was carried out to determine the effect of training on the knowledge and practices of TBAs in preventing malaria in pregnancy at Local Government Areas of Lagos State, Nigeria.

Methods: We conducted a non-randomized, controlled intervention study using balloting method to select the intervention and control communities and consenting registered TBAs. A total of 68 TBAs were included (36 in the intervention and 32 in the control groups). Following the interviewer-administered questionnaire survey, training on prevention of malaria in pregnancy was conducted for the intervention group. A questionnaire was administered three months post-intervention to assess TBAs knowledge and practices. 

Results: The training significantly increased the overall level of knowledge in the intervention group from largely poor (97.2%) to fair (86.7%) compared to the control group. However, the preventive practices did not change significantly post-intervention. We noticed a statistically significant increased number of respondents in the intervention group who counseled their clients on preventive treatment (70% compared with 0% at the baseline); insecticide-treated nets (86.7% compared with 12.5%), and referred the clients for treatment (78.6% compared with 0%) (p<0.05).

Conclusions: Lagos State Traditional Medicine Board in collaboration with other stakeholders should engage the TBAs in the ongoing efforts to prevent malaria and its complications in pregnancy by training them and monitoring the delivery of preventive treatment at the community level.