The Role of Trained Birth Attendants in Delivering PMTCT Services

Nigeria was part of an HIV epidemic that once threatened to engulf all of West Africa. The trajectory was altered by the interventions of international donor agencies such as the US President’s Emergency Plan for AIDS Relief (PEPFAR), local organizations, and other agencies who assisted in reducing the threat. Birth Attendants provide an important resource for Prevention of Mother-to-Child Transmission of HIV (PMTCT) as they are more affordable and accessible to most women living in the rural parts of poor developing countries like Nigeria. In March 2004, Faith Alive Foundation (FAF), in collaboration with Global Strategies for HIV Prevention, organized a training workshop for Traditional (trained) Birth Attendants (TBAs) providing services in Plateau State. The workshop curriculum was developed by Global Strategies for HIV Prevention and included HIV Prevention and Care, Voluntary Counseling and Testing (VCT) or HIV Counseling and Testing (HCT), safe delivery practices, and methods for sterilizing instruments. The trained TBAs were followed up by a Faith Alive project coordinator, who was responsible for providing continued oversight, record-keeping, quality assurance, and ongoing education and training. After more than 10 years of implementation and support, a program for PMTCT utilizing TBAs proved to be an important and sustainable tool for HIV Prevention. TBAs were able to provide insight into the lives of women in the community and to use their own experience to help bridge the gap between the clinical setting and the realities of culture and economics that often face women in Africa. Additionally, offering VCT to their clients and referral of HIV-positive women to Faith Alive provided another means whereby women living in remote areas were introduced to the wider healthcare network to access HIV Care and Support as well as other diseases. The role of trained traditional birth attendants should be integrated into PMTCT services in order to ensure that couples receive HCT, women recruited into PMTCT programs receive prophylaxis at the time of delivery, and opportunities are provided to access additional broad health care benefits.