Prevention of maternal mortality by training the birth attendants of church-based maternity homes in Akwa-Ibom State

  • Edem J Udoma Department of Obstetrics & Gynaecology, College of Medical Sciences, University of Calabar, Nigeria
  • Samuel M Itina
  • Asuquo D Ekanem
  • Margaret M Mboho


Context: A significant proportion of births in Nigeria still occur in spiritual churches and homes of traditional birth attendants. Recent studies have revealed a lot of complicated cases of obstructed labour from spiritual churches.

Objectives: To examine the outcome of training and integration of the spiritual church based midwives on maternal morbidity and mortality.

Design and Setting: A pre- and post-time series experimental study was conducted in five local governments of Akwa Ibom state in Nigeria.

Subjects and Methods: Fourteen churchbased clinics were visited between 1st January 2001 and 31st January 2003. Structural interview and focus group discussion were used to collect data on their midwives knowledge of 20 risk factors in pregnancy, labour and puerperium and practice of referral. Formal teaching also was given for one month on midwifery practices. After the training, they were asked to keep proper records of all pregnant women. High risk cases were referred to Anua General Hospital in Akwa Ibom State. The records were checked at six and twelve month's interval.

Results: Before the training only 10 (23.8%) midwives could recognise up to half of the listed risk factors. The knowledge and practice of referral increased significantly after training (p<0.00001 and p = 0.0000021 respectively). There were no maternal deaths.

Conclusion: We recommend that the midwives attending births in churches and other faith-based healing homes be trained and their practices integrated into the orthodox health care delivery system with regular checks by the health ministry.

Tropical Journal of Obstetrics and Gynaecology Vol. 22(2) 2005: 180-183

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eISSN: 0189-5117