Traditional birth attendants in rural Nepal: Knowledge, attitudes and practices about maternal and newborn health

N. Thatte, L. C. Mullany, S. K. Khatry, J. Katz, J. M. Tielsch, G. L. Darmstadt

Research output: Contribution to journalArticlepeer-review

16 Scopus citations


Efforts to formalise the role of traditional birth attendants (TBAs) in maternal and neonatal health programmes have had limited success. TBAs' continued attendance at home deliveries suggests the potential to influence maternal and neonatal outcomes. The objective of this qualitative study was to identify and understand the knowledge, attitudes and practices of TBAs in rural Nepal. Twenty-one trained and untrained TBAs participated in focus groups and in-depth interviews about antenatal care, delivery practices, maternal complications and newborn care. Antenatal care included advice about nutrition and tetanus toxoid (TT) immunisation, but did not include planning ahead for transport in cases of complications. Clean delivery practices were observed by most TBAs, though hand-washing practices differed by training status. There was no standard practice to identify maternal complications, such as excessive bleeding, prolonged labour, or retained placenta, and most referred outside in the event of such complications. Newborn care practices included breastfeeding with supplemental feeds, thermal care after bathing, and mustard seed oil massage. TBAs reported high job satisfaction and desire to improve their skills. Despite uncertainty regarding the role of TBAs to manage maternal complications, TBAs may be strategically placed to make potential contributions to newborn survival.

Original languageEnglish (US)
Pages (from-to)600-617
Number of pages18
JournalGlobal public health
Issue number6
StatePublished - Nov 2009


  • Knowledge attitudes practices
  • Newborn care practices
  • Traditional birth attendants

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health


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