Bringing Hope to Zambian Mothers: Training of Birth Attendants Intended to Reduce Infant Mortality

When she arrived at the Mindolo Training Farms in the Copperbelt province of Zambia, last year, Anna Knapp (MPH07) was greeted by the singing and dancing of 60 traditional birth attendants (TBAs). The Zambians had good reason to celebrate: Knapp, a senior program manager at Boston Universitys Center for International Health and Development (CIHD), had come to work on CIHDs Lufwanyama Neonatal Survival Project (LUNESP), a study that hopes to reduce the high infant mortality rate and increase the chance that Zambian children will live past their first birthday.

LUNESP trains birth attendants to intervene in four of the most common, preventable contributors to neonatal mortality: birth asphyxia, neonatal hypothermia, sepsis, and perinatal transmission of HIV.

The birth attendants often travel for days by foot, bicycle, on the backs of trucks — anyway they can — to get to the LUNESP trainings, says Knapp. And while they have to leave their families and their own responsibilities, theyre incredibly excited to receive the training that empowers them to save lives.

Since the inception of the study, which is funded by the U.S. Agency for International Development with support from the American Academy of Pediatrics, seven LUNESP faculty and staff from the CIHD, Boston Medical Center, and Tufts Medical Center have participated from Boston or traveled to Zambia to work alongside 29 Zambian staff members. With assistance from the Center for International Health and Development Zambia as well as the Lufwanyama District Health Management Team, the LUNESP team has trained 129 TBAs, as well as 16 data collectors and 12 staff members from rural health centers. The LUNESP staff is currently analyzing the data that have been collected over the past three years, and hopes that LUNESP will be expanded from a study into a district-wide program in early 2009.

For me, says Knapp, the greatest reward has been working directly with the TBAs. Theyve become masters of their training — LUNESP has helped them understand disease and illness and save lives in their communities.

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