Competing knowledge claims in the provision of antenatal care: a qualitative study of traditional birth attendants in rural Zimbabwe.

In this article we examine the role of traditional birth attendants (TBAs) in their care of women during pregnancy and childbirth, and highlight their views on the training they receive and the application of knowledge they gain. We also discuss the ways women and men reason around the practices of TBAs. Data were generated using focus group discussions and individual interviews with TBAs, women, and men. The accounts of the TBAs, women, and men indicate that the women combined traditional and professional care, reasoning that in this way they get the different forms of assurance that each offers for the proper pregnancy outcome. The accounts, moreover, suggest that little of the knowledge gained from the training, including the referral of women at high risk, was implemented. One reason for this appears to be the failure to reflect on local knowledge and realities in TBA training. We conclude that any efforts or plans to incorporate the two systems of care should acknowledge local knowledge and realities. Only then can the aim of reducing maternal and infant morbidity and mortality be achieved.