The high infant mortality in Zambia is largely attributable to malnutrition. It is exacerbated by the inability of mothers to recognise threats to nutritional status and take corrective action. Advice in Health Centres is often inaccessible to mothers. The Traditional Birth Attendants (TBAs) work with pregnant women in local communities, and the purpose of this study was to develop and implement an educationprogram in growth monitoring and nutrition for the TBAs and then to evaluate its effects. Twenty five TBAs from two peri-urban areas of Kitwe were enrolled in this pilot study and eighteen completed the program.
The researcher developed and taught a program to the TBAs over ten days. A pretest was given before the teaching program to enable the researcher to obtain information about the knowledge and skills of the TBAs. Following the teaching program the TBAs were re-tested, with the same questionnaire. Focus groups were conducted to enable the TBA to provide information on the teaching materials and the education program. The TBAs then returned to their communities and put into practice the skills and knowledge they had learned for six months. Their practice was monitored by a trained Public Health Nurse. The researcher also surveyed 38 pregnant women about their knowledge of growth monitoring and nutrition before the TBAs went into the field to work with their local communities. The same questionnaire used with the pregnant women was administered to 38 new mothers with children aged 0 to 6 months to gain information of their knowledge and skills following the work of the TBAs.
The program was evaluated by assessing the extent to which TBAs knowledge and skills were increased, the knowledge and understanding of a selection of their clients and the rates of malnutrition of infants in the area under study.
The results from the research clearly indicated that the teaching program on growth monitoring and nutrition given to the selected group of TBAs had a positive effect on their knowledge and skills. It was found that the teaching developed their knowledge, practical skills, evaluative skills. That they were able to give infants mothers sound advice regarding their childrens nutrition was revealed by the mothers increased knowledge and the decrease in numbers of malnourished children in the study areas at the conclusion of the research.
The major outcomes from the study are: that Zambian TBAs can be taught to carry out an expanded role; field experience is a key factor in the teaching program; making advice available in local communities is important; and preliminary data on the Zambian experience were generated.
Recommendations are: The pilot program should be expanded with continuing support from the Health Department. Similar educational programs should be introduced into other areas of Zambia with support from the Ministry of Health.
That in administering a teaching program: Sufficient time must be allocated to practical work to allow poorly educated women to attain the basic skills needed to master the complex skills required to competently reduce faltering in their communities. The teaching materials to illustrate nutritional principles for feeding programs must be developed to suite locally available foods and conditions. Methods of teaching should suit the local area, for example, using what facilities are locally available. The timing of the teaching program should be suitable for the TBAs to attend. This may vary from area to area, for example it may be necessary to avoid times traditionally given to fetching water or working in the fields. For similar reasons, the venue for the teaching program should be suitable to the TBAs. The teachers should go into the TBAs community rather than causing disruption of the TBAs day by expecting them to go to the teacher.
Data should be collected from a larger group of TBAs and clients to enable sophisticated statistical analysis to complement data from this pilot program.
The TBAs should be given recognition for their work and achievement. This is something which they asked for. They do not ask for payment, rather acknowledgment through regular follow up and approbation.
| Identifer | oai:union.ndltd.org:ADTP/217239 |
| Date | January 1996 |
| Creators | Mambwe, Esther, esther.membwe@dealin.edu.au |
| Publisher | Deakin University. School of Nutrition and Public Health |
| Source Sets | Australiasian Digital Theses Program |
| Language | English |
| Detected Language | English |
| Rights | http://www.deakin.edu.au/disclaimer.html), Copyright Esther Mambwe |
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