OUR PROPOSAL FOR A LAW FOR THE IMO STATE GOVERNMENT OF NIGERIA TO PROHIBIT TRADITIONAL BIRTH ATTENDANTS (TBAs) FROM ATTENDING TO PREGNANT WOMEN WITHOUT FIRST CONDUCTING HIV/AIDS SCREENING TESTS ON THEM.

1.)    Executive Summary

The recent increases in child and maternal mortality rates as a result of pregnancy related complications during child birth in the rural areas call for concern and the attention of policy makers in the country. Worse is the increase in new HIV infections from HIV + mothers to their unborn children and even to the unskilled traditional birth attendants, who are usually unprotected during the child bearing process.

In Nigeria, and in other countries of Africa, the situation is worsened by the increasing level of illiteracy and poverty among the rural population. Dilapidated and failed primary health care systems in these rural areas also aggravate the situation.

As an important and cheap alternative, pregnant women in the rural areas usually patronize "traditional birth attendants (TBAs)" during child birth. These TBAs are women, usually not well trained, half-baked retired nurses or others who use traditional medicine to deliver women of their babies. Most times, there are complications that they are not able to handle, such as hemorrhage, which may lead to the death of either the new born or the pregnant woman. Worse still is that they attend to these pregnant women without first identifying their HIV statuses, thereby exposing themselves (TBAs) and the unborn babies to HIV infection.

The risks associated with this practice are what this law seeks to address. It is an established fact that these TBAs play very important roles in assisting pregnant women deliver their babies for the mere fact that their services are affordable and easily accessible. Improving their capacities in carrying out these tasks in the rural areas through this law will help in saving more lives and in delivering affordable heath care services to people in the rural areas.

2.)    The Problem Statement

The service of delivering pregnant women of their babies by traditional birth attendants in the rural areas is an important health service that is full of risks as summarized below:

i.)    The TBAs attend to these pregnant women without knowing their HIV statuses.

ii.)   The TBAs expose themselves to HIV infection since they do not know the HIV   status of their patients and do not observe universal safety precaution.

iii.)  The unborn babies are exposed to HIV infection if their mothers are HIV +, a    situation which could be saved through Prevention of Mother To Child Transmission (PMTCT) services provided at the Federal Medical Center, Owerri, and some General Hospitals in the State.

iv.)  In cases of pregnancy related complications, such as hemorrhage, the TBAs are helpless and the lives of their patients are greatly endangered.

3.)   Project Objectives

The overall objectives of this bill / law include:

i.)   To expose the TBAs to the various health risks and complications associated with the practice of child birth

ii.)  To equip the TBAs with practical skills in HIV/AIDS prevention for themselves and their patients.

iii.) To equip the TBAs with special skills in Voluntary HIV/AIDS Counseling and Testing.

iv.) To engage the TBAs as agents and partners of the State Government in referring  HIV + pregnant women to Hospitals and centers, where they will have access to Prevention of Mother To Child Transmission (PMTCT) services.