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Meta-Analysis
. 2012 Aug 15;2012(8):CD005460.
doi: 10.1002/14651858.CD005460.pub3.

Traditional birth attendant training for improving health behaviours and pregnancy outcomes

Lynn M Sibley  1 , Theresa Ann Sipe, Danika Barry
Affiliations
Meta-Analysis

Traditional birth attendant training for improving health behaviours and pregnancy outcomes

Lynn M Sibley et al. Cochrane Database Syst Rev. .

Abstract

Background: Between the 1970s and 1990s, the World Health Organization promoted traditional birth attendant (TBA) training as one strategy to reduce maternal and neonatal mortality. To date, evidence in support of TBA training is limited but promising for some mortality outcomes.

Objectives: To assess the effects of TBA training on health behaviours and pregnancy outcomes.

Search methods: We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (18 June 2012), citation alerts from our work and reference lists of studies identified in the search.

Selection criteria: Published and unpublished randomised controlled trials (RCT), comparing trained versus untrained TBAs, additionally trained versus trained TBAs, or women cared for/living in areas served by TBAs.

Data collection and analysis: Three authors independently assessed study quality and extracted data in the original and first update review. Three authors and one external reviewer independently assessed study quality and two extracted data in this second update.

Main results: Six studies involving over 1345 TBAs, more than 32,000 women and approximately 57,000 births that examined the effects of TBA training for trained versus untrained TBAs (one study) and additionally trained TBA training versus trained TBAs (five studies) are included in this review. These studies consist of individual randomised trials (two studies) and cluster-randomised trials (four studies). The primary outcomes across the sample of studies were perinatal deaths, stillbirths and neonatal deaths (early, late and overall).Trained TBAs versus untrained TBAs: one cluster-randomised trial found a significantly lower perinatal death rate in the trained versus untrained TBA clusters (adjusted odds ratio (OR) 0.70, 95% confidence interval (CI) 0.59 to 0.83), lower stillbirth rate (adjusted OR 0.69, 95% CI 0.57 to 0.83) and lower neonatal death rate (adjusted OR 0.71, 95% CI 0.61 to 0.82). This study also found the maternal death rate was lower but not significant (adjusted OR 0.74, 95% CI 0.45 to 1.22).Additionally trained TBAs versus trained TBAs: three large cluster-randomised trials compared TBAs who received additional training in initial steps of resuscitation, including bag-valve-mask ventilation, with TBAs who had received basic training in safe, clean delivery and immediate newborn care. Basic training included mouth-to-mouth resuscitation (two studies) or bag-valve-mask resuscitation (one study). There was no significant difference in the perinatal death rate between the intervention and control clusters (one study, adjusted OR 0.79, 95% CI 0.61 to 1.02) and no significant difference in late neonatal death rate between intervention and control clusters (one study, adjusted risk ratio (RR) 0.47, 95% CI 0.20 to 1.11). The neonatal death rate, however, was 45% lower in intervention compared with the control clusters (one study, 22.8% versus 40.2%, adjusted RR 0.54, 95% CI 0.32 to 0.92).We conducted a meta-analysis on two outcomes: stillbirths and early neonatal death. There was no significant difference between the additionally trained TBAs versus trained TBAs for stillbirths (two studies, mean weighted adjusted RR 0.99, 95% CI 0.76 to 1.28) or early neonatal death rate (three studies, mean weighted adjusted RR 0.83, 95% CI 0.68 to 1.01).

Authors' conclusions: The results are promising for some outcomes (perinatal death, stillbirth and neonatal death). However, most outcomes are reported in only one study. A lack of contrast in training in the intervention and control clusters may have contributed to the null result for stillbirths and an insufficient number of studies may have contributed to the failure to achieve significance for early neonatal deaths. Despite the additional studies included in this updated systematic review, there remains insufficient evidence to establish the potential of TBA training to improve peri-neonatal mortality.

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Conflict of interest statement

None known.

Figures

1
1
'Risk of bias' graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.
2
2
'Risk of bias' summary: review authors' judgements about each risk of bias item for each included study.
3
3
Forest plot of comparison: 2 Additional training versus basic training, outcome: 2.4 Stillbirths.
4
4
Forest plot of comparison: 2 Additional training versus basic training, outcome: 2.5 Early neonatal death (0‐6 days).
1.1
1.1. Analysis
Comparison 1 Trained versus untrained TBAs, Outcome 1 Maternal deaths (number per 100,000 pregnancies).
1.2
1.2. Analysis
Comparison 1 Trained versus untrained TBAs, Outcome 2 Stillbirths (number per 1000 live births and stillbirths).
1.3
1.3. Analysis
Comparison 1 Trained versus untrained TBAs, Outcome 3 Neonatal deaths (number per 1000 live births).
1.4
1.4. Analysis
Comparison 1 Trained versus untrained TBAs, Outcome 4 Perinatal deaths (number per 1000 live births and stillbirths).
1.5
1.5. Analysis
Comparison 1 Trained versus untrained TBAs, Outcome 5 Prolonged or obstructed labour.
1.6
1.6. Analysis
Comparison 1 Trained versus untrained TBAs, Outcome 6 Postpartum haemorrhage.
1.7
1.7. Analysis
Comparison 1 Trained versus untrained TBAs, Outcome 7 Puerperal sepsis.
1.8
1.8. Analysis
Comparison 1 Trained versus untrained TBAs, Outcome 8 Referral to emergency obstetrical care.
2.1
2.1. Analysis
Comparison 2 Additionally trained versus trained TBAs, Outcome 1 Maternal deaths.
2.2
2.2. Analysis
Comparison 2 Additionally trained versus trained TBAs, Outcome 2 Perinatal mortality (0‐7 days plus stillbirths).
2.3
2.3. Analysis
Comparison 2 Additionally trained versus trained TBAs, Outcome 3 Stillbirths.
2.4
2.4. Analysis
Comparison 2 Additionally trained versus trained TBAs, Outcome 4 Early neonatal death (0‐6 days).
2.5
2.5. Analysis
Comparison 2 Additionally trained versus trained TBAs, Outcome 5 Neonatal deaths (0‐28 days, excluding stillbirths).
2.6
2.6. Analysis
Comparison 2 Additionally trained versus trained TBAs, Outcome 6 Neonatal deaths (0‐28 days, including stillbirths).
2.7
2.7. Analysis
Comparison 2 Additionally trained versus trained TBAs, Outcome 7 Late neonatal deaths (7‐28 days).
2.8
2.8. Analysis
Comparison 2 Additionally trained versus trained TBAs, Outcome 8 24‐hour neonatal mortality.
2.9
2.9. Analysis
Comparison 2 Additionally trained versus trained TBAs, Outcome 9 Postpartum haemorrhage (frequency).
2.10
2.10. Analysis
Comparison 2 Additionally trained versus trained TBAs, Outcome 10 Mean blood loss (ml).
2.11
2.11. Analysis
Comparison 2 Additionally trained versus trained TBAs, Outcome 11 Advice to feed colostrum immediately after birth.
2.12
2.12. Analysis
Comparison 2 Additionally trained versus trained TBAs, Outcome 12 Advice to give complementary food along with breast milk after 5 months of age.
2.13
2.13. Analysis
Comparison 2 Additionally trained versus trained TBAs, Outcome 13 Exclusively breastfeeding at 1‐4 weeks.
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References

References to studies included in this review

Azad 2010 {published data only (unpublished sought but not used)}
    1. Azad K, Barnett S, Banerjee B, Shaha S, Khan K, Rego AR, et al. Effect of scaling up women's groups on birth outcomes in three rural districts in Bangladesh: a cluster‐randomised controlled trial. Lancet 2010;375(9721):1193‐202. - PubMed
Bullough 1989 {published data only}
    1. Bullough CHW, Msuku RS, Karonde L. Early suckling and postpartum haemorrhage: controlled trial in deliveries by traditional birth attendants. Lancet 1989;2:522‐5. [0089] - PubMed
Carlo 2010 {published and unpublished data}
    1. Carlo WA, Goudar SS, Jehan I, Chomba E, Tshefu A, Garces A, et al. First Breath Study Group. Newborn‐care training and perinatal mortality in developing countries. New England Journal of Medicine 2010;362:614‐23. - PMC - PubMed
Gill 2011 {published data only}
    1. Gill C, Mazala G, Guerina N, Kasimba J, Knapp A, Mulenga C, et al. Reducing neonatal mortality in rural Zambia with traditional birth attendants, a cluster randomized trial: the Lufwanyama neonatal survival project (LUNESP). Pediatric Academic Societies' 2010 Annual Meeting; 2010 May 1‐4; Vancouver, Canada. 2010.
    1. Gill CJ. Lufwanyama neonatal survival project (LUNESP). ClinicalTrials.gov (http://clinicaltrials.gov/) (accessed 19 July 2010).
    1. Gill CJ, Phiri‐Mazala G, Guerina NG, Kasimba J, Mulenga C, MacLeod WB, et al. Effect of training traditional birth attendants on neonatal mortality (Lufwanyama Neonatal Survival Project): randomised controlled study. BMJ 2011;342:d346. - PMC - PubMed
    1. Guerina NG, Mazala G, Kasimba J, Mulenga C, Knapp A, Mirochnick M, et al. Effectiveness of NRP adapted for use by traditional birth attendants (TBAs) in rural Zambia: the Lufwanyama Neonatal Survival Project (LUNESP). Pediatric Academic Societies' 2010 Annual Meeting; 2010 May 1‐4; Vancouver, Canada. 2010.
Hossain 2000 {unpublished data only}
    1. Hossain Z, Ripon FH, Chowdury JH. Promotion of breastfeeding: an operations research on traditional birth attendants (TBAs) and village doctors. Unpublished report, Adabor, Shamoly, Phaka, Bangladesh: Development Support Services May 2000:1‐47. [200]
Jokhio 2005 {published data only}
    1. Jokhio AH, Winter HR, Cheng KK. An intervention involving traditional birth attendants and perinatal and maternal mortality in Pakistan. New England Journal of Medicine 2005;352(20):2091‐8. [0103] - PubMed

References to studies excluded from this review

Ajenifuja 2010 {published data only}
    1. Ajenifuja KO, Adepiti CA, Ogunniyi SO. Post partum haemorrhage in a teaching hospital in Nigeria: a 5‐year experience. African Health Sciences 2010;10(1):71‐81. - PMC - PubMed
Alisjahbana 1995 {published data only}
    1. Alisjahbana A, Williams C, Dharmayanti R, Hermawan D, Kwast BE, Koblinsky M. An integrated village maternity service to improve referral patterns in a rural area in West‐Java. International Journal of Gynecology & Obstetrics 1995;48 Suppl:S83‐S94. [0083] - PubMed
Bailey 2002 {published and unpublished data}
    1. Bailey PE, Szaszdi JA, Glover L. Obstetric complications: does training traditional birth attendants make a difference?. Pan American Journal of Public Health 2002;11(1):15‐22. [0084] - PubMed
Bang 1999 {published data only}
    1. Bang AT, Bang RA, Baitule SB, Reddy MH, Deshmukh MD. Effect of home‐based neonatal care and management of sepsis on neonatal mortality: field trials in rural India. Lancet 1999;354:1955‐61. - PubMed
Bhandari 2003 {published data only (unpublished sought but not used)}
    1. Bhandari N, Bahl R, Mazumdar S, Martines J, Black RE, Bhan MK, Infant Feeding Study Group. Effect of community‐based promotion of exclusive breastfeeding on diarrhoeal illness and growth: a cluster randomised controlled trial. Lancet 2003;361(9367):1418‐23. [10.1016/S0140‐6736(03)13134‐0 10] - PubMed
    1. Bhandari N, Mazumder S, Bahl R, Martines J, Black RE, Bhan MK, et al. Use of multiple opportunities for improving feeding practices in under‐twos within child health programmes. Health Policy & Planning 2005;20(5):328‐36. - PubMed
Bhutta 2011 {published data only}
    1. Bhutta Z, Soofi S, Cousens S, Mohammad S, Memon ZA, Ali I, et al. Improvement of perinatal and newborn care in rural Pakistan through community‐based strategies: a cluster‐randomised effectiveness trial. Lancet 2011;377:403‐12. - PubMed
Ellis 2011 {published data only}
    1. Ellis M, Azad K, Banerjee B, Shaha SK, Prost A, Rego AR, et al. Intrapartum‐related stillbirths and neonatal deaths in rural Bangladesh: a prospective, community‐based cohort study. Pediatrics 2011;127(5):e1182‐90. [DOI: 10.1542/peds.2010-0842] - DOI - PubMed
Falle 2009 {published data only}
    1. Falle TY, Mullany LC, Thatte N, Khatry SK, LeClerq SC, Darmstadt GL, et al. Potential role of traditional birth attendants in neonatal healthcare in rural southern Nepal. Journal of Health, Population and Nutrition 2010;27(1):53‐61. - PMC - PubMed
Gloyd 2001 {published data only}
    1. Gloyd S, Floriano F, Seunda M, Chadreque MA, Nyangezi JM, Platas A. Impact of traditional birth attendant training in Mozambique: a controlled study. Journal of Midwifery & Women's Health 2001;46(4):210‐6. [0095] - PubMed
Greenwood 1999 {published data only}
    1. Greenwood AM, Bradley AK, Byass P, Greenwood BM, Snow RW, Bennet S, et al. Evaluation of primary health care programme in The Gambia. The impact of trained traditional birth attendants on the outcome of pregnancy. Journal of Tropical Medicine and Hygiene 1990;93:58‐66. - PubMed
John 2002 {published data only}
    1. John ME, Udoma EJ, Udoh MO, Ndebbio TJ, Idiong MS. Knowledge and practice of traditional birth attendants concerning risk factors in pregnancy, labour and puerperium. Africa Journal of Nursing and Midwifery 2002;4(1):41‐5.
Menendez 1994a {published data only}
    1. Menendez C, Todd J, Alonso PL, Francis N, Lulat S, Ceesay S, et al. The effects of iron supplementation during pregnancy, given by traditional birth attendants, on the prevalence of anaemia and malaria. Transactions of the Royal Society of Tropical Medicine and Hygiene 1994;88:590‐3. [0112] - PubMed
Menendez 1994b {published data only}
    1. Menendez C, Todd J, Alonso PL, Lulat S, Francis N, Greenwood BM. Malaria chemoprophylaxis, infection of the placenta and birth weight in Gambian primigravidae. Journal of Tropical Medicine and Hygiene 1994;97:244‐8. [0111] - PubMed
Nyamwaya 1993 {unpublished data only}
    1. Nyamwaya D, Morgan R, Lukhando M, Fisher A, Ndhlovu L. Expanding family planning delivery systems using traditional health practitioners: an operations research study in rural Kenya. Unpublished report, Population Council's Africa Operations Research and Technical Assistance Project, Nairobi, Kenya 1993.
O'Rourke 1994 {unpublished data only}
    1. O'Rourke KM. The effect of a traditional birth attendant training program on obstetrical practices and perinatal mortality in rural Guatemala [dissertation]. Amerherst: University of Massachusetts, 1994.
Olusanya 2011 {published data only}
    1. Olusanya BO, Inem VA, Abosede OA. Infants delivered in maternity homes run by traditional birth attendants in Urban Nigeria: a community‐based study. Health Care for Women International 2011;32(6):474‐91. [DOI: 10.1080/07399332.2011.565531] - DOI - PubMed
Prata 2005 {published data only}
    1. Prata N, Mbaruku G, Campbell M, Potts M, Vahidnia F. Controlling postpartum hemorrhage after home births in Tanzania. International Journal of Gynecology & Obstetrics 2005;90:51‐5. [0122] - PubMed
Rahman 1982 {published data only}
    1. Rahman S. The effect of traditional birth attendants and tetanus toxoid in reduction of neonatal mortality. Journal of Tropical Pediatrics 1982;28(4):163‐5. - PubMed
Rowen 2009 {published data only}
    1. Rowen T, Prata N, Passano P. Evaluation of a traditional birth attendant training programme in Bangladesh. Midwifery 2011;27(2):229‐36. [DOI: 10.1016/j.midw.2009.06.003] - DOI - PubMed
Saravanan 2011 {published data only}
    1. Saravanan S, Turrell G, Johnson H, Fraser J, Patterson C. Traditional birth attendant training and local birthing practices in India. Evaluation and Program Planning 2011;34(3):254‐65. - PubMed
Satishchandra 2009 {published data only}
    1. Satishchandra DM, Naik VA, Wantamutte AS, Mallapur MD. Impact of training of traditional birth attendants on the newborn care. Indian Journal of Pediatrics 2009;76(1):33‐6. - PubMed
Singhal 2001 {published data only}
    1. Singhal N, McMillan DD. Problem‐based teaching of birth attendants in the Philippines. Health Care for Women International 2001;22:569‐83. [0127] - PubMed
Theron 1999 {published data only}
    1. Theron GB. Effect of the maternal care manual of the perinatal education programme on the ability of midwives to interpret antenatal cards and partograms. Journal of Perinatology 1999;19(6):432‐5. [0008] - PubMed
Theron 2000 {published data only}
    1. Theron GB. Improved practical skills of midwives practicing in the Eastern Cape Province of the Republic of South Africa through the study of a self‐education manual. Journal of Perinatology 2000;3:184‐8. [0004] - PubMed

References to studies awaiting assessment

Costello 2011 {published data only}
    1. Costello A. Improving newborn care and outcomes through training of traditional birth attendants in use of bag and mask resuscitation in three rural districts in Bangladesh. Current Controlled Trials (www.controlled‐trials.com) (accessed 27 June 2011).
Matendo 2011 {published data only}
    1. Matendo R, Engmann C, Ditekemena J, Gado J, Tshefu A, Kinoshita R, et al. Reduced perinatal mortality following enhanced training of birth attendants in the Democratic Republic of Congo: a time‐dependent effect. BMC Medicine 2011;9:93. - PMC - PubMed
Morrison 2011 {published data only}
    1. Morrison J, Tumbahangphe KM, Budhathoki B, Neupane R, Sen A, Dahal K, et al. Community mobilisation and health management committee strengthening to increase birth attendance by trained health workers in rural Makwanpur, Nepal: study protocol for a cluster randomised controlled trial. Trials 2011;12:128. - PMC - PubMed
Pasha 2010 {published data only}
    1. Pasha O, Goldenberg RL, McClure EM, Saleem S, Goudar SS, Althabe F, et al. Communities, birth attendants and health facilities: a continuum of emergency maternal and newborn care (the Global Network's EmONC trial). BMC Pregnancy and Childbirth 2010;10:82. - PMC - PubMed

Additional references

Bang 1994
    1. Bang AT, Bang RA, Sontakk PG, SEARCH Team. Management of childhood pneumonia by traditional birth attendants. Bulletin of the World Health Organization 1994;72(6):897‐905. - PMC - PubMed
Bergstrom 2001
    1. Bergstrom S, Goodburn E. The role of traditional birth attendants in the reduction of maternal mortality. In: Brouwere V, Lerberghe VW editor(s). Safe Motherhood Strategies: a Review of the Evidence, Studies in Health Services Organization and Policy. Vol. 17, Antwerp: ITG Press, 2001.
Buekens 2003
    1. Buekens P. Review of: traditional birth attendant training effectiveness: a meta‐analysis, LM Sibley, TA Sipe. International Journal of Gynecology & Obstetrics 2003;83:121‐2. - PubMed
Darmstadt 2009
    1. Darmstadt GL, Lee AC, Cousens S, Sibley L, Bhutta ZA Donnay F, et al. 60 million non‐facility births: who can deliver in community settings to reduce intrapartum‐related deaths?. International Journal of Gynecology & Obstetrics 2009;107(Suppl 1):S89–S112. - PMC - PubMed
Egger 1997
    1. Egger M, Davey Smith G, Schneider M, Minder C. Bias in meta‐analysis detected by a simple, graphical test. BMJ 1997;315(7109):629‐34. - PMC - PubMed
Filippi 2000
    1. Filippi V, Ronsmans C, Gandaho T, Graham W, Alihonou E, Santos P. Women's self‐report of severe (near‐miss) obstetric complications in Benin. Studies in Family Planning 2000;31(4):309‐24. - PubMed
Fortney 1997a
    1. Fortney JA, Smith JB. Training of Traditional Birth Attendants: Issues and Controversies. Durham, NC: Family Health International and United Nations Children's Fund, 1997.
Fortney 1997b
    1. Fortney JA, Smith JB. Methodological Issues in Research on Traditional Birth Attendants. Durham, NC: Family Health International and United Nations Children's Fund, 1997.
Harbord 2006
    1. Harbord RM, Egger M, Sterne JA. A modified test for small‐study effects in meta‐analyses of controlled trials with binary endpoints. Statistics in Medicine 2006;25(20):3443‐57. - PubMed
Higgins 2005
    1. Higgins JPT, Green S, editors. Cochrane Handbook for Systematic Reviews of Interventions 4.2.5 [updated May 2005]. http://www.cochrane.org/resources/handbook/hbook.htm (accessed 31 May 2005).
Higgins 2011
    1. Higgins JPT, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [updated March 2011]. The Cochrane Collaboration, 2011. Available from www.cochrane‐handbook.org.
Khan 2006
    1. Khan KS, Say L, Gülmezoglu AM, Look PF. WHO analysis of causes of maternal death: a systematic review. Lancet 2006;367(9516):1066‐74. - PubMed
Kumar 1998
    1. Kumar R. Effectiveness of training traditional birth attendants for management of asphyxia neonatorum using resuscitation equipment. Prenatal and Neonatal Medicine 1998;3(2):225‐60.
Lassi 2010
    1. Lassi ZS, Haider BA, Bhutta ZA. Community‐based intervention packages for reducing maternal and neonatal morbidity and mortality and improving neonatal outcomes. Cochrane Database of Systematic Reviews 2010, Issue 11. [DOI: 10.1002/14651858.CD007754.pub2] - DOI - PubMed
Lawn 2005
    1. Lawn JE, Cousens S, Zupan J, Lancet Neonatal Survival Steering Team. 4 million neonatal deaths: who, when? where? why?. Lancet 2005;365(9462):891‐900. - PubMed
Levitt 1997
    1. Levitt MJ. When the training of TBAs is cost effective: trained TBAs and neonatal essential care in South Asia. Improving health of the neonate and infant in developing countries (conference draft). London: Kathmandu Mother and Infant Research Activities (MIRA) and Institute of Child Health, University College Medical School, 1997.
Maine 1992
    1. Maine D. Cost‐effectiveness of different safe motherhood options. Safe Motherhood Supplement. Geneva: World Health Organization, 1992.
Maine 1993
    1. Maine D. Safe Motherhood Programs: Options and Issues. New York: Columbia University School of Public Health, Prevention of Maternal Mortality, Center for Population and Family Health, 1993.
Marsh 2003
    1. Marsh D, Sadruddin S, Fickree FF, Krishnan C, Darmstadt G. Validation of verbal autopsy to determine cause of death in 137 neonatal deaths in Karachi, Pakistan. Pediatric and Perinatal Epidemiology 2003;17(2):132‐42. - PubMed
Measure DHS 2002
    1. Measure Demographic and Health Surveys. Macro International. http://www.measuredhs.com/ (accessed 2011) 2002.
Measure DHS 2011
    1. Measure Demographic and Health Surveys. Macro International. http://www.measuredhs.com/ (accessed 2011) 2011.
Miller 2003
    1. Miller S, Sloan N, Winikoff B, Langer A, Fikree F. Where is the "E" in MCH? The need for an evidence‐based approach in safe motherhood. Journal of Midwifery & Women's Health 2003;48(1):10‐8. - PubMed
Osrin 2010
    1. Osrin D, Prost A. Perinatal interventions and survival in resource‐poor settings: which work, which don't, which have the jury out?. Archives of Disease in Childhood 2010;95(12):1039‐46. [DOI: 10.1136/adc.2009.179366] - DOI - PMC - PubMed
RevMan 2003 [Computer program]
    1. The Cochrane Collaboration. Review Manager (RevMan). Version 4.2 for Windows. Oxford, England: The Cochrane Collaboration, 2003.
RevMan 2011 [Computer program]
    1. The Nordic Cochrane Centre, The Cochrane Collaboration. Review Manager (RevMan). Version 5.1. Copenhagen: The Nordic Cochrane Centre, The Cochrane Collaboration, 2011.
Ronsmans 1997
    1. Ronsmans C, Achadi E, Cohen S, Zazri A. Women's recall of obstetric complications in South Kalimantan, Indonesia. Studies in Family Planning 1997;28:203‐14. - PubMed
Sibley 2002
    1. Sibley LM, Sipe TA. Effectiveness of Traditional Birth Attendant Training: a Meta‐analysis. Final Technical Report. Washington, DC: Academy for Educational Development (SARA Project), 2002.
Sibley 2004a
    1. Sibley L, Sipe TA, Koblinsky M. Does TBA training increase use of professional antenatal care services: a review of the evidence. Journal of Midwifery & Women's Health 2004;49(4):298‐305. - PubMed
Sibley 2004b
    1. Sibley L, Sipe TA, Koblinsky M. Does TBA training improve referral of obstetric complications: a review of the evidence. Social Science and Medicine 2004;59(8):1757‐68. - PubMed
Sibley 2004c
    1. Sibley L, Sipe TA. Traditional birth attendant training and pregnancy outcomes: what can meta‐analysis tell us?. Midwifery 2004;20(1):51‐60. - PubMed
Starrs 1998
    1. Starrs A, Inter‐Agency Group for Safe Motherhood (IAGSM). The safe motherhood action agenda: priorities for the next decade. Report of the safe motherhood technical consultation; 1997 October 18‐23; Colombo, Sri Lanka. New York: Family Care, International and the Inter‐Agency Group for Safe Motherhood, 1998.
Tinker 1993
    1. Tinker A, Koblinsky M. Making Motherhood Safe. Washington, DC: World Bank, 1993.
UNICEF 1997
    1. United Nations International Children's Education Fund. Report on the consultation on attendance at birth: community birth attendants; 1997 June 9‐10. New York: Health Section, Programme Division, United Nations Children's Fund, 1997.
WHO 1992
    1. World Health Organization. Traditional birth attendants: a joint WHO/UNICEF/UNFPA statement. Geneva: World Health Organization, 1992.
WHO 1995
    1. World Health Organization. Verbal autopsies for maternal death. WHO/FHE/MSM/95.15. Geneva: World Health Organization, 1995.
WHO 1999
    1. World Health Organization. A standard verbal autopsy method for causes of death in infants and children. WHO/CDS/CSR/ISR/99/4. Geneva: World Health Organization, 1999.
WHO 2006
    1. World Health Organization. Neonatal and Perinatal Mortality: Country, Regional and Global Estimates. Geneva: WHO, 2006.
WHO 2007
    1. World Health Organization. Maternal Mortality in 2005: Estimates Developed by WHO, UNICEF, UNFPA, and the World Bank. Geneva: WHO, 2007.
WHO 2010a
    1. World Health Organization. Optimizing the delivery of key interventions to attain MDGs 4 and 5, Optimize4 MNH: background document for the first expert scoping meeting to develop WHO recommendations to optimise health workers’ roles to improve maternal and newborn health. Geneva: WHO, 6‐8 December 2010.
WHO 2010b
    1. World Health Organization. Trends in Maternal Mortality: 1990 to 2008: Estimates Developed by WHO, UNICEF, UNFPA and the World Bank. Geneva: WHO, 2010.

References to other published versions of this review

Sibley 2007
    1. Sibley LM, Sipe TA, Brown CM, Diallo MM, McNatt K, Habarta N. Traditional birth attendant training for improving health behaviours and pregnancy outcomes. Cochrane Database of Systematic Reviews 2007, Issue 3. [DOI: 10.1002/14651858.CD005460.pub2] - DOI - PubMed

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