252 Traditional Birth Attendants In The Primary Health Care System Of Egypt
The "Daya" is a local female delivery practitioner widespread for centuries in low-income communities of Egypt, by whom she is needed and respected. During the last few years Daya (traditional birth attendant, T.B.A.) training programs have been a major intervention, aiming at improving their performance and linking them to local primary health care institutions (PHC). The aim of this study was to assess T.B.A. training and supervision through PHC and to recommend standards for quality assurance of their role in the system. Four districts in Sharkia governorate were randomly chosen, in two of which (Zagazig and Minea Al-Kamh, with a total of 72 days), the daya training program had been implemented. While in the other two (Diarbenegm and Elibrahimia with a total of 78 days) no training had been performed. The study included fulfilment of check-lists to qualitatively and quantitatively assess daya kits equipment, supplies and utilization; TBA KAP questionnaires; and TBA performance observation sheets for a subsample of TBAs. Results showed that TBAs ranging between 30-60 years of age, 98% illiterate, were all weakly related to PHC facilities. However, supervision over 32% of trained versus 4% of untrained was evident. Knowledge, attitude and practice of trained were clearly better than untrained, but scores hardly exceeded 50%. Observation showed that dayas still did not perform any antenatal care or referral and that their role started at delivery. Recommended periodical training and regular supervision standards through PHC are discussed.
252 Traditional Birth Attendants in the Primary Health Care System of Egypt