A HISTORY OF TRADITIONAL BIRTH ATTENDANTS AND MATERNAL HEALTH IN GHANA, 1931 – 1992

ABSTRACT Before the introduction of conventional midwifery, Traditional Birth Attendants (TBAs) or indigenous midwives were the only maternal healthcare providers. With the introduction of conventional midwifery came the introduction of policies to scrutinize the practices of TBAs. These policies depicted efforts to ban TBAs and eradicate the reliance of pregnant women on TBAs. No research has explored policies affecting TBAs and how they affected their status as the original providers of maternal healthcare. This thesis historicized the policies affecting TBA practices from 1931 when the Midwives Ordinance was passed, to 1992, when the National Reorientation project for TBAs ended. Using archival documents including official government documents such as legislative debates, annual reports and policy briefs amongst others, this research has shown that the policy that affected indigenous midwives or TBAs during the colonial and postcolonial period mainly sought to gradually remove them from the system, to allow a dependence on conventional healthcare. These policies affected the roles that TBAs played over the years, and also caused certain undesirable perceptions about TBA practices. However, TBAs could not be removed from the system due to the inability of the government to provide conventional healthcare to all areas in Ghana. TBA reorientation and inclusion into the formal healthcare system became necessary for the government to use already available resource. In rolling out these reorientation programmes however, the government and policy makers failed to consider the social and cultural dispositions of TBAs.