LU 
Nomvo Henda & Karl Peltzer 
Traditional Birth Attendants in the Eastern Cape, South Africa: 
Characteristics, Role and HIV/AIDS 
NOMVO HENDA & KARL PELTZER 
Abstract The aim of this study was to conduct formative research on a sample of traditional birth attendants 
(TBAs), their characteristics, role and HIV/AIDS in the Eastern Cape, South Africa. The sample included 30 TBAs 
from seven villages in region E in the Eastern Cape. Results indicate that most TBAs had not been trained, had 
assisted on average 16.5 deliveries during their practice, and mostly assisted in delivery in emergency (if the preg- 
nant woman could not make it to the hospital). Further, labour and delivery process (called in, position of head of 
baby, position of women during delivery, the birth process, umbilical cord and placenta, care of baby/mother, dif. 
ficulties in the birth process), rituals (herbs/home remedy, placenta and cord and child care), and knowledge, be- 
liefs and practices on HIV/AIDS are described. 
Traditionelle Gebursthelferinnen in Eastern Cape, Südafrika: Charakteristiken, Aufgabe und HIV/Aids 
Zusammenfassung Das Ziel dieser formativen Studie war, in einer Stichprobe die Merkmale, die Rolle und das 
Wissen zu HIV/Aids von traditionellen Geburtshelferinnen (TGH) in der Provinz Eastern Cape, Südafrika, zu be- 
schreiben. Die Stichprobe bestand aus 30 TGH aus sieben Dörfern der Region E in “Eastern Cape”. Ergebnisse der 
Studie zeigten: die meisten TGH waren nicht ausgebildet, hatten im Durchschnitt 16.5 Geburtshilfen in ihrer Pra- 
xiszeit geleistet und wurden hauptsächlich im Notfall zur Geburtshilfe gerufen, inbesondere wenn das Kranken- 
haus zur Geburt nicht erreicht werden konnte. Es werden weiterhin der Ablauf der Wehen und des 
Geburtsprozesses beschrieben (bestellte Einsätze, Position des Kopfes von Baby, Position der Frau während der 
Geburt, der Geburtsvorgang, Nabelschnur und Gebärmutter, Fürsorge des Babies/Mutter, Probleme während des 
Geburtsvorganges), sowie Rituale (Heilkräuter/Hausmittel, Plazenta und Nabelschnur sowie Babypflege) und 
Wissen, Glaubensvorstellungen und Praktiken hinsichtlich HIV/Ajids. 
Keywords (Schlagwörter) Traditional birth attendants (Traditionelle Geburtshelferinnen) — characteristics of 
TBA (Merkmale der TBAs) — professional role of TBA — practices of TBA — birthgiving rituals (Geburtsgebräu- 
che) - HIV/AIDS and Childbirth (HIV/Aids und Geburt) — Eastern Cape — South Africa (Südafrika) 
Introduction 
A Traditional Birth Attendant (TBA) is defined, 
based on the South African Bill to establish the In- 
terim Traditional Health Practitioners Council, as a 
person who engages in traditional health practice 
and is registered under this act (DEPARTMENT OF 
HEALTH 2004). According to midwives (NOLTE 
1998) TBAs can be characterized in South Africa as 
follows, she is a middle aged or elderly lady with no 
formal training, who acquired her skills through ex- 
perience. She attends to women during pregnancy, 
labour and the postnatal period in different ways 
that have been used by the TBA are mainly herbs 
that facilitate a quick delivery, or others that cause 
bleeding of the uterus postnataly. Other TBAs use 
no medicine. The DEPARTMENT OF HEALTH (2004) 
notes that the role of traditional birth attendants in 
prenatal care for the mother includes advice or in- 
structions as to what to eat, what not to eat, the giv- 
ing of herbal remedies for pain, sickness or discom- 
fort. They do abdominal massages and offer comfor! 
to mothers, giving them a sense of security. They 
also assist with the delivery of the baby and advise 
and assist the new mother on how to care for the 
baby after it is born. A number of authors have indi- 
cated the importance of traditional birth attendance 
in the delivery of health care to the mother and child 
in South Africa (JEPSON & MACDONALD 1988, 
LARSEN 1983, NOLTE 1998, SELEPE & THOMAS 
2000, TROSKIE 1997). 
RAY and SALIHU (2004) review that TBAs and 
village midwives have been employed in many in- 
terventions to reduce maternal mortality in develop- 
ing countries. Five of the five programmes reviewed 
‘hat evaluated their impact on maternal mortality 
demonstrated a decline in maternal mortality ratios, 
two of three studies measuring morbidity-related in- 
dicators found improvement of some but not all 
morbidity outcomes, six of seven showed a trend of 
improved referral rates, and three of three found 
aigh levels of knowledge retention among trained 
Curare 28(2005)2+3: 310-320