Problem-based teaching of birth attendants in the Philippines

Abstract

We compared the effects of lecture-style (L) and interactive problem-based (I) educational programs on knowledge, attitude, and practices (KAP) of traditional birth attendants in the Philippines. Participants in two cities were randomized to L and I teaching groups and completed a questionnaire pre-, immediately post-, and 6 months after education. Mothers reported practices of the attendants. There was significant improvement in mean knowledge scores (L 16.8 to 17.9 and I 16.4 to 19.3) in group I. Group I scores continued to improve 6 months later. Attitude scores significantly improved in both groups and decreased 6 months later, indicating a need for reinforcement. Certain undesirable practices such as late cord clamping and holding the baby upside down following birth were changed in both groups. Actual practices reported by mothers were carried out less frequently than indicated by providers, indicating a need for further education and possibly provision of adequate resources. Interactive (I) learning is a preferred method for education of traditional birth attendants.