AIM The aim of this study is threefold; to assess the knowledge, practices and beliefs of the traditional birth attendant TBA in two urban slum areas in Addis Ababa. It aims at studying the informal health system of the TBAs, the peri-natal care of mother and child and the enculturation of new TBAs, and what factors in the urban context influence the system. It also aims at describing what factors influence knowledge changes within the group of TBAs.
Internationally the World Health Organisation WHO already in called for a change in attitudes towards greater emphasis on the traditional health care system as a natural part of primary health care. Traditional knowledge can be valuable not only to the developing countries but also to the industrialized part of the world, as the multi-cultural dimensions of society expands. Traditional health care practices need to be investigated so that beneficial methods and results can be preserved and supported and hazardous ones can be negotiated and restructured.
This is part of a holistic approach to health matters which can contribute to modern medicine and health practices Negussie, Using traditional benign practices as the ground for developing appropriate and effective training programs for primary health workers in developing countries is one, and maybe the most obvious, benefit that can be gained from such research. An increasing maternal mortality and a very slow decline in infant mortality rates in the third world UNICEF, are yet other urgent reasons to investigate present traditional practices and underlying systems of knowledge and beliefs.
Such information is also necessary for a "modern society" if we want to educate our health workers to provide the culturally most appropriate care for those who seek our health services Leininger, Sweden is rapidly changing into a multi-cultural society and we can no longer hope that our own traditional "caring ways" in the health sector will be sufficient for or appropriate to all the different groups of people that already live or will come to live in our country. We need to expand our competence on different levels.
To increase our competence in this area we need to assess the peri-natal knowledge, practices and beliefs of the TBA, including the enculturation of new TBAs', in the local society itself. Secondly there is a need to assess the needs of health care seekers from other cultures in our own health system and finally to scientifically assess the competence of Swedish health workers in culture-related care.
