Two years ago nine Rshi women from the Phialor cluster of villages wanted to help pregnant women in their villages. With the support of World Renew and their local partner in Laos, these women were trained as Traditional Birth Attendants. In addition to information about actual care for expectant mothers, the training was designed to overcome language and literacy barriers using creative, practical methods like videos, role playing, and picture lesson books.

With the support of World Renew and their local partner in Laos, these women were trained as Traditional Birth Attendants. In addition to information about actual care for expectant mothers, the training was designed to overcome language and literacy barriers using creative, practical methods like videos, role playing, and picture lesson books.

In February of this year, a health consultant met with the birth attendants for a short review session.  Because the World Renew and partner teams had focussed on other challenges in the past two years, there had been only limited follow-up and no further training in the intervening two years. The consultant asked them to role play assisting with a delivery and was astonished to see how they managed, as a group, to reproduce with much precision, the training received 2 years earlier!  

During the roleplay, the group of birth attendants:

• demonstrated great care and support to the laboring woman

• gave water to the laboring woman

• walked with the pregnant woman in labor

• used soap to wash hands (putting on gloves is still something they need to practice!)

• checked for the position of the head

• dried the baby after birth, but did not remove the wet cloth

• placed the baby skin-to-skin with the mother directly after birth and after the cord was cut

• measured the proper distance to clamp the cord and cut it safely

• delivered the placenta and checked for completeness

• remembered, with no prompting, to check for maternal danger signs such as anemia, oedema, headache, dizziness, back pain, tiredness, anorexia, hemorrhage, unconsciousness — significantly more than they could identify during the training 2 years ago  

Many steps were well done and proved that the use of videos, roleplaying, and illustrations work effectively in training women without Lao language or literacy skills. The consultant felt confident in entrusting the TBA’s to provide Vitamin B1 to pregnant and new mothers to prevent beriberi, which is common in the region.

The World Renew Cambodia team is so encouraged to learn about the birth attendants’ involvement in the community and their active support of mothers. They have proven to be key players in promoting health messages to reduce infant mortality. They have proved that, despite language, cultural, and education barriers, they are able to learn and be agents of change in their communities.

Story written by Pascale Chantavong, Health Consultant for World Renew Laos