Orthodox and unorthodox practices by traditional birth attendants in Nsukka area of Enugu State, Southeast Nigeria

Unskilled Traditional Birth Attendants (TBA) is prevalent in rural Nigeria due to communal culture and traditions, their compassionate attitude, and non-availability of appropriate health facilities within the communities. Yet, there is no clear framework defining their roles, locations and practices. This study aimed to identify the pattern and practices of TBA in Nsukka area of Enugu State, and evaluate their roles in rural maternity services in Enugu state of Nigeria. This was a mixed method cross sectional study involving a questionnaire-based survey and Focus group discussions (FGD). Seventy-eight TBAs, were recruited for this study. Structured interviewer-administered questionnaire was used to collect quantitative data and a semi-structured discussion guide was used for the FGD – one FGD for each development center. SPSS version 25 was used for statistical analysis. Records of FGD sessions were transcribed, condensed into themes, and analyzed. A total of 78 TBAs were interviewed, 26 from each of the three development areas. Majority (66.0%) completed primary education while 9.0% did not have any formal education. Almost two-third (65.4%) uses exclusively traditional methods in their practice, whereas 34.5% combined orthodox method. Three focused group discussions showed almost all the TBAs in the study could neither identify different complications and when to refer nor signs separating different stages of labour. Poorly educated TBA in the Nsukka area of Enugu State combines orthodox medicine with herbs and traditional healing methods. Their appreciation and management of danger pregnancy signs and referral system are lacking. Key words: Traditional birth attendants, healthcare, Nsukka, informal health, Labor.