Timidi Digha-Omolere: Why Women Still Ignore Ondo State Government’s Ban On Traditional Birth Attendants

I have always been intrigued by the concept of Traditional Birth Attendants [TBA]; in fact out of curiosity I once attended their antenatal classes a few times during one of my pregnancies. I have also added my voice to demand for training and empowerment of TBAs.

I moved to Akure in June 2014 and restless me began to look for things to do. It was during one of my restless trips that I learnt of the ban on Traditional Birth Attendants in the state.

Traditional Birth Attendants in Ondo State were banned and warned from attending to pregnant women. Some of them were trained on different skills such as bead making, soap making etc with the promise of some micro finance facilities to start other businesses, monthly stipend to be given to TBAs plus the referral money they get anytime they refer a client to Mother and Child, the state owned hospitals for Mothers and Children. The services at Mother and Child are mostly free.

August 2014, The Traditional Birth Attendants opposed the ban and held a town hall meeting to make this clear. It was during this meeting that the Commissioner for Health, Dr Dayo Adeyanju, said TBAs would face legal action over any death recorded in their hands.

While I laud what Ondo State Government is doing with Mother and Child and the Iya Abiye project, which is aimed at reducing maternal and neonatal deaths and making services affordable and accessible; to reduce Maternal and Neonatal mortality we need all hands on board, Traditional Birth Attendants inclusive (or at least so I think) but Ondo state thinks differently.

I have always said Traditional Birth Attendants should be trained so they become TTBAs (Trained Traditional Birth Attendants) or SBAs (Skilled Birth Attendants (not like they are not already skilled).

This report is a summary of interviews conducted with 3 Traditional Birth Attendants in Ondo State who pleaded anonymity but gave their nicknames and refused photography or video coverage.

Iya Rere (TBA/FGM guru)

What struck me most about Iya Rere is the fact that she lives and operates her TBA in one of the highbrow areas of Akure, in fact the outer appearance of her house doesn’t give it off as a Birth Attendant Spot or “Iya Agbebi” as popularly called. You will think the females trooping in and out are going to buy things in bulk (she has a big provision store in front of her house).

I got in and was asked to register but I told her I wasn’t pregnant. She had young ladies dressed in nurse like apparels made of Ankara. Tush TBA. I told her my mission; I simply wanted to know how the ban was affecting her work as a TBA. She smiled and made me promise to hide her identity.

She said the ban hasn’t affected her like many others because she provides HCT (HIV Counseling and Testing), Herbal concoctions asides the drugs she administers, prayer sessions, follow up and especially Female Genital Mutilation. That caught my attention.

I had to wait till the end of the day before she could attend to me without any distraction. She says many mothers even the educated ones and those that have their babies in the state provided facilities come to her for Herbal Concoctions for both the Mother and Child and FGM for the girl children to avoid promiscuity. I hate hearing that as the reason for FGM.

Anyway, she charges between 1000-5000 for FGM depending on the size and age of the person to be “mutilated” and type to be carried out though she mostly pricks or cuts off the clitoris.

On the average she delivers at least 50 babies per week.

Quick, proud and confident in what she does, she took me round her facility, which could pass off as an accredited health centre.

Her parting words were “No matter the ban women would look for us and patronize us, Government should stop deceiving themselves and work with us”.

I promised to be back, maybe I will witness FGM happening and write about that.

 

Mamma Referral

Her job is basically to refer but she refers both ways. She says her Spot is always under scrutiny because of its location and her pedigree, a lot of people knows her. She claims to have assisted many government officials during delivery that is why she gave up active attending.

She refers mostly to the state owned facility but sometimes refers to other TBAs still operating with some stipend assured from both ends. She says most women prefer TBAs because they understand, caring, supportive and non-judgmental unlike hospital staffs that are quick to put you in your place and even offer unsolicited advice. People also complain that the state owned facilities are always filled and would take your time before being attended to. Who no like free thing?

Mama Referral says she misses being a TBA and assists her colleagues whenever the need arises as she is very good in Caesarian Section and feels the government didn’t carry out its research well before banning TBAs.

 

Anonymous

She refused to give a name or nickname saying both are very popular and she didn’t want to get in trouble with the government.

She laughed when I asked how business was. Her answer was “won ma lo ile iwosan, lehin iyen won ma wa” meaning they will go to the hospitals and come here afterwards. I was shocked.

She claimed many of them come to show her the drugs they were given and if it okay to use them, some come to her for checkups, in fact many she said would come when labour had started and when their dilation had increased they would go to the hospital. She also said she accompanies some who are very scared posing as their mother. Now that is trust. Serious trust.

Her last words “Ko ye Mimiko rara, Aye Agbebi yato” meaning Mimiko doesn’t understand at all, the role of Traditional Birth Attendants is different.

I want to play the advocate for both ends after studying what they do but mostly for the TBAs. Ondo State government shouldn’t have banned them just like that, they should have worked with them and like life coaching does give them reasons to stop working. The force and threats is breeding revolt.

Many of these TBAs are dirty, not all are inviting, Government needs to work with them, empower them with knowledge and training on cleanliness, the need to refer and make it seem like symbiosis-mutually beneficial relationship. That way its win-win for all involved- government, TBAs, mothers and children.

 

 

  • Dr Adeyinka Onikan

    Thank you for the article. I however support the government’s decision. Many TBAs are old women set on their ways and mostly untrainable, they cause more harm than good( eg. FGM, transmission of infectious diseases etc). Their existence is mostly as a result of failed primary health care system. Even though some people still patronize them they will eventually feezle with the ban. I will rather encourage the state government to make primary health care more accessible and affordable in order to avoid existence of unskilled health workforce who worsen the maternal mortality ratio in the country which is currently one of the worst in the world.

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