ROLE OF TRADITIONAL MIDWIVES IN THE MODERN HEALTH SECTOR IN WEST AND CENTRAL AFRICA

Each country is discussed separately in regard to demography, health facilities and personnel. Also included is information on the roles and training of midwives, and relationships between the traditional and modern health sectors. All five countries share similar problems in the rural health sector: shortage of qualified health personnel and facilities; unequal distribution favoring urban areas; and underutilization of existing facilities and personnel in rural areas. Although a trend to expand TBA training programs is indicated, various obstacles must be considered. These include government attitudes toward TBA"s, attitudes of health professionals, attitudes of TBA"s toward training, conflict between traditional and modern health sectors, and various problems with the content and methods of training programs. A set of guidelines for integrating traditional midwives into the modern health sector is provided. Recommendations are made regarding the expansion and dissemination of knowledge about TBA"s and evaluation methods. Appended in French are outlines for existing TBA training courses. Thirty-seven references to general works on the topic, and additional references specific to the five countries are given in French and English. Also listed are the names of the author"s personal contacts in the five countries.