The coun­try of Sierra Leone has the sec­ond high­est child mor­tal­ity rate in the world. The med­ical pro­fes­sion­als in the coun­try blame the high death rate on mid­wifes or tra­di­tional birth attendants.

The health pro­fes­sion­als say that mid­wifes do not have the proper train­ing if preg­nan­cies get com­pli­cated. How­ever, the mid­wifes way that they are needed to reach remote vil­lages where there is no access to medicine.

From the Voice of Amer­ica, writer Chinedu Offor frames the debate in this story.

Sierra Leone has the sec­ond high­est child mor­tal­ity rate in the world, accord­ing to a recent sur­vey by UNICEF and the World Health Orga­ni­za­tion (WHO). The report found that more than one out of four chil­dren die before their fifth birthday.

The death rate among new­borns in Sierra Leone is above the aver­age for Africa, at 56 per 1,000 live births, says the WHO.

Doc­tors in gov­ern­ment hos­pi­tals blame tra­di­tional birth atten­dants (TBAs) for the high death rate. They’re blamed for not being able to han­dle prob­lem births, includ­ing hemorrhaging.

But the atten­dants say they have a major role to play, espe­cially in a coun­try where poverty, poor trans­porta­tion and cul­tural prac­tices keep many women from going to the hospital.

Dr. Ibrahim Thor­lie is the chief med­ical offi­cer of the Princess Chris­t­ian Mater­nity and Child Health clinic in East End, Freetown. .

“In my own opin­ion, the TBAs have no role to play in the reduc­tion of mater­nal mor­tal­ity because they deal with the nor­mal case that does not cause mater­nal mor­tal­ity. There­fore, we should stop train­ing them.”

A tra­di­tional birth atten­dant super­vi­sor, Mohammed Masere, dis­agrees. He says Dr. Thorlie’s views are extreme.

“At (the) pri­mary health­care level, TBAs have a role to play because they are closer to the peo­ple in the com­mu­nity. They do deliv­er­ies, cases that are unable to reach the health facil­i­ties on time.”

Tele­vi­sion per­son­al­ity Woteh Cam­era was deliv­ered by a TBA, and she agrees. With most of the pop­u­la­tion liv­ing in rural areas and unable to access hos­pi­tal ser­vices, she says, tra­di­tional birth atten­dants remain rel­e­vant. But they should be trained in mod­ern meth­ods of deliv­ery, she adds.

“Though they are not well trained, I think they are doing a good job, as most peo­ple will say, [in view of the fact] that we don’t have qual­i­fied peo­ple in our rural areas, most espe­cially the remote vil­lages where…the roads are bad and it (the clinic or hos­pi­tal) is far.”

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