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Table 2 Implementation factors linked to systematic review outcomes

From: Establishing partnership with traditional birth attendants for improved maternal and newborn health: a review of factors influencing implementation

Studies from systematic review that report overall improvement in care seeking outcomes Findings from synthesis of factors influencing implementation
Author, year Country, setting Facilitating factors critical to successful outcomes Barriers to successful outcomes
Fauveau et al., 1991 [6] BANGLADESH, rural Matlab Collaborative working between trained midwives, nurse-midwives, CHW’s and TBAs
- Integration of TBAs into a ‘referral chain’ working with skilled personnel
- Continued adherence to traditionalism and traditional practices
- Men as main decision-makers in the family may be unwilling to seek external assistance
Frankenberg et al., 2009 [4] INDONESIA - Collaborative relationships with TBAs identified as a duty of trained midwives posted in villages - Greater degree of traditionalism in some villages where trained midwife posted
Gabrysch et al., 2009 [19] PERU, Ayacucho rural Santillana district - Adopting a participatory approach including TBAs and family members to design culturally appropriate childbirth services
- TBAs accommodated as birth companions to help with pushing and giving drinks and to provide a culturally appropriate facility birth
- TBAs involved in capacity building workshops with other health workers
- Providers continuing to ascribe high levels of home births as due to ‘cultural preference’ or ‘ignorance’ rather than offering culturally accessible services
Mullany et al., 2010 [7] MYANMAR, Shan, Mon, Karen, and Karenni regions - Integration of TBA into a 3 tiered network of community based providers
- Training of HWs and TBAs to strengthen their working relationship
- TBAs used to create links between community members and senior health workers
- TBAs used to provide improved ANC
- Supervision of TBA role a responsibility of MHWs
 
Purdin et al., 2009 [13] PAKISTAN, Hangu district, Afghan refugee camp - TBAs provided with reproductive health (RH) training along with other community members
- TBAs active in awareness raising, including RH
 
Ronsmans et al., 2001 [5] INDONESIA, three districts in South Kalimantan - Village midwives encouraged to strengthen their relationships with TBAs
- TBAs identified as one of several ‘key decision-makers’
- TBAs involved in accessing information, education and communication (IEC) materials for community use