Traditional birth attendants (TBAs) are regarded as essential child health care providers in Bangladesh. A community-based cross-sectional study was completed using questionnaires and interviews to compare trained and untrained TBAs' advice on (1) breast-feeding, (2) immunizations and (3) oral rehydration therapy as an extended part of their maternity care training. Twenty-eight trained TBAs (TTBAs) and 27 corresponding untrained TBAs (UTBAs) in the Dhaka district were interviewed to investigate the effect of their advice on the three outcome variables of maternal health care. Additionally, 276 questionnaires were distributed to the mothers cared for by these TBAs to determine their knowledge of infant-care practices. In-depth interviews with 25 mothers provided additional insight. While TTBAs may have more knowledge and be more willing to disseminate health care information to mothers with new infants than UTBAs, the mother's health practices were independent of the advice provided by the two groups of TBAs. Additionally, the mother's health practices equaled or exceeded expected norms.
PIP: A cross-sectional study conducted in rural Bangladesh's Dhaka District compared the appropriateness and accuracy of advice given by 28 trained and 27 untrained traditional birth attendants (TBAs) on breast-feeding, immunization, and oral rehydration. In addition, perceptions of care provided by trained and untrained TBAs were analyzed through a questionnaire administered to 276 clients of these TBAs. TBAs in both groups tended to be poor, married, Islamic women with no formal education. Although the trained TBAs provided more accurate information than their untrained counterparts in terms of breast-feeding, colostrum, and when to introduce solid foods, mothers' breast-feeding knowledge and practices were unrelated to whether they had been cared for by a trained or untrained TBA. Similarly, while trained TBAs provided more correct information on both immunization and oral rehydration therapy, mothers' adherence to immunization schedules and use of rehydration when their child had diarrhea were not affected by the type of TBA who provided care. Both groups of TBAs reported providing more information to mothers about these three issues than mothers reported receiving from the TBAs. In general, maternal health practices met or exceeded expected norms.