Ekua Sekyerewa – Traditional midwife at Taido, Central Region
Imagine you are a pregnant woman in an extremely remote rural area of the country, with terrible roads and hardly any mobile network service. Imagine you have started going into labor and you rush to the woman in the community who has delivered practically every baby in the area. Now imagine that, when you get there, instead of attending to you and helping deliver your baby, she starts trying to call for transport to the nearest hospital (which is about 30 minutes away). Imagine your shock when she tells you that now, by law, she is not allowed to deliver babies, but only facilitate getting you to the hospital. This is the dilemma facing Traditional Birth Attendants like Ekua Sekyerewa in Taido, a remote village in the Central Region of Ghana.
A World Health Organisation (WHO) directive has asked these TBAs (who, in essence, are midwives), to stop delivering babies and rather encourage women to deliver at hospitals. Of course, Ekua doesn’t really turn these women away. She is considered a local heroine in Taido, having delivered thousands of babies over the course of 20 years. So is this directive a fair one? Knowing the reality on the ground with locations such as Taido, is it right to stop these traditional midwives, who are so essential and valuable to the communities they serve, from performing their duty? Clearly a traditional midwife like Ekua has developed and honed her skills in delivering babies over such a long period of time. All she needs is perhaps some formal training and to be equipped better to handle the cases in her village. Apparently, in the past, the government used to provide this training to TBAs. So why did it stop? Given the terrible state of the roads in Taido and in countless other remote areas in the country, providing ambulances or alternative means of dedicated healthcare transport seems like a dream that may only come to fruition further in the future. So the focus should be on tangible and workable solutions for the present, and it seems obvious that the majority of people, looking at Taido as an example, would disagree sharply with the WHO’s stand on Traditional Birth Assistants.
We all know the deplorable state of our healthcare systems in rural areas, so of course these need to be built up and improved as soon as possible. We also know that these areas are in dire need of trained midwives who are fully equipped and prepared to handle deliveries in their local towns and villages. These are things that are needed now, but unfortunately are not yet set up. So, while waiting for this to happen, dedicated heroines like Ekua Sekyerewa will and should continue to provide this essential and desperately needed service to their local communities.
Do you agree with the WHO directive to stop TBAs from delivering babies?
What measures do you think should be taken to improve the situation of traditional midwives like Ekua Sekyerewa?
mhcghana 
They shd be given some formal training,they are useful
In every stage of project initiation and planning, the context within which the initiative is to be implement is indeed critical for a successful programme. The WHO talks about skilled delivery and yet many of women do not easily access it. Women travel long distances to access skilled personnel. The time has come for us to make use of the resources we have. We should give these TBAs the necessary training for the short term while in the long term we seek to provide every community with a qualified mid-wife.
A simple answer here is NO! I think they should be empowered, equipped to help out, not just once but regularly. Like a first aid for women in such rural areas. I think it’s fantastic what they do, but they should be educated so that they can ditch some myths they have. I think then we’re actually solving a problem. Going to a hospital is not always the answer, these hospitals are under resourced anyway, let make use of the options we have and a person’s willing nature to do this job.