The Role of Informal Providers in Managing Pregnancy and Childbirth Related Conditions in Slum Areas in Dhaka City

In Bangladesh, it is seen that informal health care providers play an important role in managing pregnancy related conditions both in rural and urban areas. Only 18% of childbirths are attended by skilled providers while the... [ view full abstract ]

In Bangladesh, it is seen that informal health care providers play an important role in managing pregnancy related conditions both in rural and urban areas. Only 18% of childbirths are attended by skilled providers while the rest are attended by various categories of alternative and non-medically trained providers. This study aimed to explore the practices of informal health care providers in relation to pregnancy and childbirth in slum areas.

The study was conducted in Korail slum of Dhaka city in Bangladesh. Qualitative methods such as in-depth interviews, FGDs and listing were utilized to gather information from the health care providers.

The study reveals that informal providers such as village doctor, homeopaths, faith healers and traditional birth attendants (TBAs) were the primary source for managing complications related to pregnancy and child birth in slum areas. Though village doctors, homeopaths and faith healers did not conduct delivery directly, in many cases there were called on by TBAs to accelerate the pain during childbirth. It was common practice among village doctor to push intra venous (IV) saline and injection to accelerate delivery. Likewise, homeopaths provided homeopathy medicine for prolonged or obstructed labour, while faith healers treated with holy water, holy verses, amulet, and medicinal plants. Data also reveals that some providers who managed complications such as eclampsia, bleeding, retained placenta, prolonged labour, malpresentation of foetus were involved in harmful practices. They also delayed in referring mothers with complications, who required immediate referral to qualified doctors or hospitals.

An integrated initiative should be taken to ensure rationale practices in pregnancy and childbirth by the different types of informal health care providers in the slums.