Often considered as untrained and potential unsafe service providers who may utilise harmful practices. Conversely there are often positive associations through the provision of pastoral care and support to women. In many instances the relationship between TBAs; health workers and policy makers is complex and underpinned by issues such as cultural sensitivity; women’s preferences; accessibility; affordability and status.
A number of interventions have attempted to train and/or reorient TBAs to provide specific and/or alternative services to complement the aim of every birth being attended by a skilled attendant and care across the continuum. The evidence for impact in reducing maternal deaths appears inconclusive.