DIMARUCOT, Nasser L.

NUR2023 - DWETCN
BSN 403 Ms. Mayla D.V. Rivera

Maternal and Child Health has and always has been a very important factor in
the health field as the worlds’ population is dominated by women and their capacity to
bring forth life. Access to prenatal checkups, delivery rooms, early infant care, and
postpartum are essential needs of a mother and child as this ensures quality health to
both beings. Absence of such leads to not only maternal death but also infant death.
This issue is prominent in the country of Sierra Leone in Africa who for a decade
witnessed the violence of war and has suffered its effects. This produced the downfall of
infrastructures including medical ones that catered to the sick and poor. What really
stands out in the issue is the country has a high illiteracy rate meaning individuals
cannot comprehend what is being said thus leading to non-compliance with instruction.
Correlating this to maternal and child health, we can align this to the increased maternal
mortality rate (MMR) and infant mortality rate (IMR). Dorwie & Pacquiao (2014),
supports this claim in their study that Sierra Leone has the highest record of Maternal
Mortality Rate.

Given the factors that hinder pregnant mothers to deliver in a hospital setting
such as the additional fees to be paid, the distance of the health facility from their
homes, and the unpleasant attitudes of care providers (Dorwie & Pacquiao, 2014),
pregnant pregnant in preparation for childbirth prefer traditional birth attendants despite
their lack of clinical skill in deliveries are respected and well-sought because of their
experience in child delivery. Although valued by most pregnant mothers to assist in
childbirth, the Ministry of Health and Sanitation of Sierra Leone introduced the mandate
of referring women to perform delivery in a hospital setting and subsequently banning
TBA’s in the process. This is now an ethical dilemma as the banning of TBA’s is
associated with the rise of maternal mortality rate in Sierra Leone.

Women have the right to choose which type of care they prefer and the
preference of a TBA in a country whose literacy rate is below average is already a good
start. Although, we cannot really avoid the risks it will produce without proper training,
sterility, and back-up. Through Dula Pacquiao’s Model, we can refigure the problem the
situation to as the preference for TBA’s will be the compassion, the inclusion of TBA’s in
the mandate of the Ministry of Health and Sanitation in maternal health and delivery
covers the collaboration of the two entities, social justice will be the acknowledgement
DIMARUCOT, Nasser L. NUR2023 - DWETCN
BSN 403 Ms. Mayla D.V. Rivera

and appreciation of TBA’s as crucial partner of health upholding beliefs, and as for
human rights, the right of choose of women is sufficed as they have a reliable partner to
translate and help them understand the complexities of modern health care in maternal
health.

To further address the issue, cultural accommodation and cultural repatterning

should be integrated in deliveries of pregnant women in Sierra Leone. Given their
inability to comprehend, TBA’s with the assistance of nurses and midwives can
collaborate on the needs of the mother as the TBA will serve as the bridge of
communication between the pregnant and the healthcare providers. This strategy not
only builds new relationships between two parties but also ensures the safe delivery of
the baby.

References

Dorwie, F. M., & Pacquiao, D. F. (2014). Practices of Traditional Birth Attendants in Sierra Leone
and Perceptions by Mothers and Health Professionals Familiar With Their Care. Journal of
Transcultural Nursing, 25(I), 33-41. DOI: 10.1177/1043659613503874