Abstract
Introduction. In hard-to-reach indigenous communities in the state of Guerrero, Mexico, traditional birth attendants are the only trained personnel available for prenatal care and childbirth. The importance of linking nurses and physicians with traditional birth attendants arises from the inability of health systems to provide maternal care, especially in rural areas. Objective. Explore the Model of Knowledge, Attitudes, Subjective Norms, Intention to Change, Agency, Discussion and Action –CASCADA- in nurses and physicians regarding traditional midwifery in Xochistlahuaca, Guerrero. Methodology. Qualitative and descriptive study. Twenty-one in-depth interviews were conducted: 11 with physicians and 10 with nurses from the Basic Community Hospital and Health Centers of Xochistlahuaca, following the CASCADA model. The selection criterion involved medical personnel having contact with traditional birth attendants in the last twelve months. The work observed ethical guidelines and principles related to studies involving human participation. For the assessment, a priori codes and categories were identified. Results. Health personnel, aware of the loss of traditional midwifery, expressed positive and negative attitudes toward traditional birth attendants; health workers reported that traditional midwifery is worth developing, showed intention to change behavior, and presented the capacity to implement it. Conclusions. Health workers recognized that the decline in traditional midwifery would lead to more complications in pregnant women and even more maternal deaths, so they were willing to undertake behavior change actions to develop traditional midwifery.
References
Cortés-González RE. La falta de personal médico en México en el contexto de la pandemia de Covid-19: ¿El programa de medicina para graduados es la solución? Salud Publ Mex [Internet]. 2021 [citado 29 nov 2023];63(4):264-465. Disponible en: https://saludpublica.mx/index.php/spm/article/view/12248
Fondo de Población de las Naciones Unidas (FPNU). El estado de las matronas en el mundo 2021. FPNU [Internet]. Nueva York; 2022 [citado 15 feb 2023]. Disponible en: https://www.unfpa.org/sites/default/files/pub-pdf/21-038-UNFPA-SoWMy2021-Report-ESv7131.pdf
Arista L. México tiene un déficit de 200,000 médicos y 300,000 enfermeras, reconoce salud. Expansión Política [Internet]. 2020 [citado 08 feb 2023]. Disponible en: https://politica.expansion.mx/presidencia/2020/04/07/mexico-deficit-200-000-medicos-y-300-000-enfermeras
Ebifa OJ, Abiakam C, Elechi-Amadi KZ, Giami LK, Briggs ON. Assessment of the role of traditional birth attendants (TBAs) in Asaba, Nigeria. Asian Journal of Medical Principles and Clinical Practice [Internet]. 2021 [citado 18 abr 2024];4(4):127-131. Disponible en: https://journalajmpcp.com/index.php/AJMPCP/article/view/95/189.
Sarmiento I, Zuluaga G, Paredes-Solis S, Chomat AM, Loutfi D, Cockcroft A, et al. Bridging western and indigenous knowledge through intercultural dialogue: Lessons from participatory research in México. BMJ Glob Health [Internet]. 2020 [citado 09 oct 2022];5e002488. Disponible en: https://gh.bmj.com/content/5/9/e002488
Musie MR, Mulaudzi FM. Knowledge and attitudes of midwives towards collaboration with traditional birth attendants for maternal and neonatal healthcare services in rural communities in South Africa. Midwifery [Internet]. 2024 [citado 18 abr 2024]:130:103925. Disponible en: https://doi.org/10.1016/j.midw.2024.103925
Guraraa M, Muyldermansc K, Jacquemynd Y, Van-Geertruydene JP, Draulansf V. Traditional birth attendants’ roles and homebirth choices in Ethiopia: A qualitative study. Women Birth [Internet]. 2020 [citado 18 abr 2024];33:e464-e472. Disponible en: http://dx.doi.org/10.1016/j.wombi.2019.09.004
Alarcón-Lavín R, Alarcón-Salazar TA, Álvarez-Romo D, Aranda-Miranda V, Araya-Morales MJ, Brandão T, et al. Las parterías tradicionales en América Latina. Cambios y continuidades ante un etnocidio programado. 1ª ed. Puerto Rico: Luscinia C. E. 2021.
Instituto Nacional de Estadística y Geografía (INEGI). Características de los nacimientos registrados en México durante el 2020. Comunicado de prensa [Internet]. INEGI; 2021 [citado 13 nov 2023]. Disponible en https://www.inegi.org.mx/contenidos/saladeprensa/boletines/2021/EstSociodemo/NamtosRegistrados2020.pdf
Instituto Nacional de Salud Pública. La partería profesional en México ¿hacia dónde va? [Internet]. México; 2020 [citado 13 nov 2023]. Disponible en: https://www.insp.mx/avisos/4315-seminario-parteria-insp.html
Curry D, Islam MA, Sarker BK, Laterra A, Khandaker, I. A novel approach to frontline health worker support: a case study in increasing social power among private, fee-for-service birthing attendants in rural Bangladesh. Hum Resour Health [Internet]. 2023 [citado 18 abr 2024];21(1):7-15. Disponible en: https://doi.org/10.1186/s12960-022-00773-6.
Nacht A, Rivera C, Bunge MS, Jimenez ZA, Lamb M, Bolaños A, et al. The addition of traditional birth attendant care to a home-based skilled nursing program in rural Guatemala: A secondary analysis from a quality improvement database. J Midwifery Womens Health [Internet]. 2022 [citado 21 sep 2022];67(1):107-113. Disponible en: https://pubmed.ncbi.nlm.nih.gov/35060659/
Freyermuth G. Los caminos para parir en México en el siglo XXI. Experiencias de investigación vinculación, formación y comunicación. 1ª ed. Ciudad de México: Centro de Investigación y Estudios Superiores en Antropología Social. 2018.
Stevenson M. Health behavior change theories and models. En Snelling AM (Ed.) Introduction to health promotion. 2a ed. Estados Unidos de Norteamérica: John Wiley & Sons; 2023. Pp. 23-42.
Pimentel J, Cockcroft A, Andersson Neil. Impact of game jam learning about cultural safety in Colombian medical education: A randomised controlled trial. BMC Med Educ [Internet]. 2021 [citado 29 nov 2023];21(132). Disponible en: https://doi.org/10.1186/s12909-021-02545-7
Fondo de Población de las Naciones Unidas (FPNA). El estado de las parteras en el mundo 2014. Hacia el acceso universal a la salud, un derecho de la mujer. FPNA [Internet]. Nueva York; 2014 [citado 02 mar 2023]. Disponible en: https://www.unfpa.org/sites/default/files/pub-pdf/SoWMy2014_complete-Spanish.pdf
Fuster-Guillen DE. Investigación cualitativa: método fenomenológico hermenéutico. Propós. Represent [Internet]. 2019 [citado 02 mar 2024];7(1):201-229. Disponible en: http://dx.doi.org/10.20511/pyr2019.v7n1.267
Vizcaíno-Zuñiga PI, Cedeño-Cedeño RJ, Maldonado-Palacios IA. Metodología de la investigación científica: guía práctica. Ciencia Latina Revista Científica Multidisciplinar [Internet]. 2023 [citado 02 mar 2024];7(4):9723-9762. Disponible en: https://doi.org/10.37811/cl_rcm.v7i4.7658
Ahmed H, Westering JV, Shikur Z, Terefa FG, Challa A, Sharma R, et al. The effectiveness of radio talk shows by UNICEF Ethiopia in increasing knowledge and changing attitudes and behaviors around child marriage, female genital mutilation, and gender equality. Adv. Soc. Sci. Res. J [Internet]. 2023 [citado 15 abr 2024];10(11):61-75. Disponible en: https://doi.org/10.14738/assrj.1011.15797
Majid U, Wasim A, Bakshi S, Truong, J. Knowledge, (mis-)conceptions, risk perception, and behavior change during pandemics: A scoping review of 149 studies. Public Unders. Sci. [Internet]. 2020 [citado 15 abr 2024];29(8):777-799. Disponible en: https://doi.org/10.1177/0963662520963365
Kestler E, Walker D, Bonvecchio A, Sáenz-de Tejada S, Donner A. A matched pair cluster randomized implementation trail to measure the effectiveness of an intervention package aiming to decrease perinatal mortality and increase institution-based obstetric care among indigenous women in Guatemala: study protocol. BMC Pregnancy Childbirth [Internet]. 2013 [citado 25 may 2023];13(73):1-11. Disponible en: https://doi.org/10.1186/1471-2393-13-73
Khayame HA, Abdeljawad MM. Systems thinking in upstream social marketing: using soft systems methodology to improve midwifery policy in Jordan. Soc Mar Q [Internet]. 2020 [citado 25 may 2023];26(2):167-183. Disponible en: https://journals.sagepub.com/doi/10.1177/1524500420925810
Laureano-Eugenio J, Villaseñor-Farías M, Mejía-Mendoza ML, Ramírez-Cordero H. Ejercicio tradicional de la partería frente a su profesionalización: estudio de caso en Jalisco, México. Rev. Fac. Nac. Salud Pública [Internet]. 2016 [citado 25 may 2023];34(3):275-284. Disponible en: https://doi.org/10.17533/udea.rfnsp.v34n3a02
Jiménez S, Pelcastre B, Figueroa JG. Parteras tradicionales y su relación con las instituciones de salud. Entre la resistencia y la subordinación. Rev Chil Salud Pública [Internet]. 2008 [citado 27 may 2023];12(3):161-168. Disponible en: https://revistasaludpublica.uchile.cl/index.php/RCSP/article/view/2205
Wilson A, Gallos ID, Plana N, Lissauer D, Khan KS, Zamora J, et al. Effectiveness of strategies incorporating training and support of traditional birth attendants on perinatal and maternal mortality: meta-analysis. BMJ [Internet]. 2011 [citado 26 may 2023];343:d7102. Disponible en: https://doi.org/10.1136/bmj.d7102
Llamas A, Mayhew S. Five hundred years of medicine gone to waste? Negotiating the implementation of an intercultural health policy in the Ecuadorian Andes. BMC Public Health [Internet]. 2018 [citado 27 may 2023];18:686. Disponible en https://doi.org/10.1186/s12889-018-5601-8
Dorwie FM, Pacquiao DF. Practices of traditional birth attendants in Sierra Leone and perceptions by mothers and health professionals familiar with their care. J Transcult Nurs [Internet]. 2014 [citado 28 may 2023];25(1):33-41. Disponible en: https://journals.sagepub.com/doi/10.1177/1043659613503874.
Kim SS, Nguyen PH, Tran LM, Alayon S, Menon P, Frongillo EA. Different combinations of behavior change interventions and frequencies of interpersonal contacts are associated with infant and young child Feeding practices in Bangladesh, Ethiopia, and Vietnam. Curr. Dev. Nutr. [Internet]. 2020 [citado 14 abr 2024];4(2). Disponible en: https://doi.org/10.1093/cdn/nzz140
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