Role of traditional birth attendants in the dissemination of advice on nutrition

Abstract

Nutritionists conducted a rapid assessment of nutrition advice dissemination to pregnant and lactating mothers by 35 traditional birth attendants (TBAs) after they underwent 3 training sessions in Samburu district, Kenya. Almost 90% of mother sought their advice both before and after delivery. 2 pregnant women came to them each month. 8 of the 9 TBAs who were key informants provided the mothers with dietary advice especially what foods not to eat. In fact, no TBA suggested the pregnant and lactating mothers increase caloric intake especially during the last 2-3 months of pregnancy. People in Samburu do not believe they should increase eating. TBAs advised women to drink milk and eat meat from healthy animals and meat soups with herbs and chili. They believed eating chili would keep the fetus from growing too large. Before eating chili, the women were supposed to not eat some meals or vomit to prevent large fetal size. The herbs made up somewhat for the vitamin C they missed from eating only small amounts of fresh fruit and vegetables. Forbidden foods included camel milk, and some wild fruits, milk and meat from ill animals, meat from animals bitten by snakes, and meat from animals who died a natural death. All the TBAs helped the mothers for a short period after childbirth by preparing their food and feeding them. They advised postpartum women to eat and/or drink blood, meant, meat soups, maize meal porridge, and milk because these foods would increase breast milk production and improve the mothers' health. TBAs also counseled women on what to eat if there were complications. For example, women who were dizzy and fainted should drink more cow blood and eat more liver, meat, and meat soup. This was appropriate since these high iron foods would address anemia which the symptoms indicated was the complication. Health workers should include TBAs in nutrition education pre- and postnatally.