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Maternal mortality in Ghana: is there a place for traditional birth attendants (TBAs) as reporters of maternal mortality-related data?


 Analysis of hospital records from January 1983 to December 1985 at the Komfo Anokye Teaching Hospital in Kumasi, Ghana revealed a maternal mortality rate of 12.5/1000 births. During this period, 27,592 births and 342 maternal deaths occurred. The primary cause of death was hemorrhage(32.14%). Other leading causes of maternal deaths include hepatic failure (19.53%),postpartum hemorrhage (18.75%), eclampsia (11.01%), sepsis (10.71%), ruptured uterus (8.33%), and anemia (4.76%). Comparison of deaths with clinic attendants and non-clinic attendants revealed 43.68% more deaths with non-clinic attendants. 29.02% of the maternal deaths were among primipara and 31.09% among grandmultipara. Furthermore, 41.9% of the deaths were among women 24 years. A health profile of the Ashanti-Akim district indicated 14.8% of the population are females in the reproductive range; 47.1% live in areas having a population of 500; 55.1% reside within a 8 km radius of a health center; a 1:19,500 physician/population ratio; 45% greater home births in rural areas and 9% in urban areas; traditional birth attendants (TBAs) delivered 63% of all births. Adequate data gathering and maternal death registration are current problems. Through education, TBAs could collect available information on maternal mortality, make regular visits to the areas, and bring awareness to the population of the need for medical care. TBAs could provide a valuable contribution to the health care systems in improving maternal-child health and assist in reducing maternal mortality rates.
