In partnership with the Department of Higher Education, Science and Technology (DHEST), UKZN hosted the first of its kind conference on the critical role played by traditional midwives – known as Traditional Birth Attendants (TBAs) – in communities around the country and in various developing countries.
The two-day conference themed: Restoring African Dignity through Traditional Birth Attendants, aimed to pave the way for ‘mapping the knowledge and skills of TBAs, and developing norms and standards against which their competencies can be assessed, thereby contributing to the formal recognition of the discipline’. This follows requests from TBAs to the government to formally recognise their work.
According to DHEST, while the majority of the country’s births take place in hospitals, traditional birth attendance continues to play a significant role in the lives of many rural communities, and forms an important part of indigenous knowledge-based sexual and reproductive healthcare systems. Despite this, the practice continues to suffer widespread marginalisation.
The conference offered TBAs from around the country an opportunity to share knowledge, skills and experience on the challenges they face in carrying out their work, and to protect, promote and develop indigenous knowledge systems.
DHEST is the custodian of the Protection, Promotion, Development and Management of the Indigenous Knowledge Bill that is expected to be enacted by the sixth Parliament. It aims to protect, archive and develop South Africa’s vast storage of indigenous knowledge.
In her welcome address, Deputy Vice-Chancellor and Head of the College of Health Sciences, Professor Busisiwe Ncama said that the role of TBAs cannot be over-emphasised as they provide basic healthcare, support and advice to pregnant women in their communities, especially in rural and remote areas where health services are under resourced. She added that they bring with them rich knowledge and years of experience gained from their ancestors.
Ncama commended DHEST and the University’s Centre in Indigenous Knowledge Systems (CIKS) for organising the conference and for challenging TBAs’ marginalisation.
Challenges raised by TBAs included the shortage or delay of ambulances as some call centres take long to respond; a lack of supplies and resources; the ill treatment they suffer at the hands of health workers when they take the mother and baby to hospital after the birth; and lack of compensation for their work. The rise in teenage pregnancies is another reason a number of young people are giving birth at home, as they are either too embarrassed to visit health clinics or want to hide the pregnancy from their parents.
Dr Mlungisi Cele from DHEST thanked the TBAs for being part of the conversation, and for their commitment and dedication to their work. He noted that many communities still rely on IKS methods to survive, and that TBAs in rural areas and informal settlements are part of that knowledge.
Cele added that the conference would hopefully, assist in ensuring that TBAs are formally and professionally recognised like nurses and doctors; this depends on all stakeholders working together. He said the Department will continue to monitor the implementation of the agreed norms and standards finalised at the conference.
Dr Andrea Mason from the Harmonic Connection Plus Institute in the USA, who spoke on reclaiming and embracing TBAs’ knowledge and African practices in the Diaspora, praised TBAs for holding on to tradition. She observed that African American traditional midwives have been stripped of their culture and family traditions adding that while legislation is important, holding on to traditions and protecting IKS is just as significant.
Ms Olive Tengera from the School of Nursing and Midwifery at the University of Rwanda looked at the challenges and prospects for TBA education in African Higher Education. She said the lack of support as well as other resources are some of the challenges faced by TBAs in Rwanda. She noted the need for linkages between TBAs and the health system and for countries to get together to share best practices.
As the way forward, DHEST will consolidate the challenges noted during the conference and facilitate the discussion with other partner departments. Since the norms and standards were validated during the conference, DHEST will continue to launch the Recognition of Prior Learning (RPL) pilot process in KwaZulu-Natal; and the finalisation of the norms and standards in all provinces will continue noting the budgetary constraints.
Words: Sithembile Shabangu
Photographs: Albert Hirasen