Skilled or Traditional Birth Attendant? Choices of Communities in Lukulu District, Rural Zambia

OBJECTIVE: To analyse factors that contribute to the choice of either traditional birth attendants (TBAs) or skilled birth attendants (SBAs) by inhabitants of Zambia's Lukulu District. DESIGN: Cross-sectional descriptive survey. SETTINGS: Lukulu District, Western Province, Zambia. POPULATION: 1413 participants: parous women, their husbands, village headmen and elderly women. MAIN OUTCOME MEASURES: Preferred and actual place of birth. METHODS: Questionnaires, structured interviews and focus group discussions. RESULTS: 42% of women gave birth in a health facility, assisted by SBAs; 75: prefer to give birth in a health facility; many barriers are to be passed for women to reach a skilled attendant in time. CONCLUSION: Skilled birth attendants are preferred to assist at childbirth in Lukulu District. Transportation problems, sociocultural reasons and unpreparedness still cause the majority of women to turn to traditional birth attendants. Traditional birth attendants should not yet be excluded from safe motherhood programs.