Berkley Center

As an International Health major, my time abroad was spent completing an internship, as opposed to taking traditional coursework. Insights into my research project and elements of Tanzanian culture will be documented in this post. With a passion for maternal-child health and guidance from my preceptor, I developed a project to look at three primary objectives: 1. Traditional birth attendants’ (TBAs) level of knowledge; 2. The quality of care they provided during delivery; and 3. A woman’s motivations for choosing a TBA-assisted delivery. The study design process began with an extensive review of the existing literature, followed by the creation of the study tool: a survey-interview. The unique survey-interviews for the woman and TBA populations had both quantitative sections and open-ended questions that constituted the qualitative sections, producing a mixed methods study. The data was back-translated to English and analyzed for statistical significance.

The topic of TBAs particularly interested me because of their relative nonexistence in the United States. However, that is not to say that we do not have a range of healthcare providers for antenatal care in the United States. Midwives and doulas are two groups that come mind when considering those who provide antenatal, delivery, and postnatal services—“antenatal” meaning during pregnancy or before delivery, while “postnatal” means after delivery. During the spring semester of my junior year, I interned at a community level health clinic called the Family Health and Birth Center (FHBC), located in northeast Washington, DC. Staffed with midwives, family nurse practitioners, pediatricians, etc., they specialized in providing care to women and their families from pregnancy onward. One hallmark of FHBC’s work was the group classes they had twice a month for mothers with due dates near one another. At roughly 10 women per class, they would come, sometimes with their partner or children, to learn and share their experiences. One parallel that I think could be drawn between this internship and my Tanzanian one is that, in Tanzania, women often viewed TBAs as a source of knowledge in addition to experience; therefore, a woman would have the opportunity to learn about the health of herself and of her unborn baby through visits with the TBA. My research found that women visited the health clinic for antenatal services but also visited TBAs, and ultimately delivered with the latter.

While conducting interviews and gathering data in the field, I observed was that people were very trusting and allowed you to hold and play with their young children. One contributing factor to this could be the larger family units in Tanzania. According to a comprehensive survey on Tanzania’s demographic and health indicators, the average Tanzanian household consists of five people. This contrasts to the latest data from the US Census which reports that the average American household consists of 2.6 individuals. When children grow up in larger families, it can be anticipated that they spend time with many people whom they can trust. Also, the child’s biological parents are more likely to share their parenting responsibilities with other members of her family. Through my experiences, I found that parents, specifically mothers, were more open to letting me to hold their little ones than I have seen in the United States. I feel that the communal nature of families, influenced by the generousness of Swahili culture, contributes to this.

Traditionally, women in Tanzania carry their children (from a couple of months to a couple of years old) on their back, wrapped in a traditional piece of colorful, printed fabric called a kanga. My research assistant approached a group of ladies and asked a woman if she would be okay with putting her baby on my back. The smiling woman untied the kanga from her torso and wrapped it around mine, securely fastening her four month old on my back, allowing me to experience this tradition. Asante sana (thank you very much) to everyone who made this semester incredibly memorable.