Context and reasons of preference for use of traditional birth attendant care in Indonesia and Ethiopia

Despite progress achieved in improving maternal health in Indonesia and Ethiopia, both countries still have high maternal deaths. To address this key issue, the Indonesian and Ethiopian governments prioritise health facility childbirth and discourage the use of Traditional Birth Attendant (TBA) care. The study aims to explore context and reasons of preference to use TBA care in Indonesia and Ethiopia. Employing a qualitative approach, 110 semi-structured interviews (SSIs) and 7 focus group discussions (FGDs) in Cianjur and Southwest Sumba (Indonesia), as well as 44 SSIs and 14 FGDs in Sidama (Ethiopia) were conducted. Study participants included mothers, TBAs, community health providers, men within those communities and village leaders. The study found that preference for TBA care persists in the study sites within both countries. TBAs' cultural, psychological and geographical proximity, TBAs' wide-ranging and culturally deep-rooted services are important context and reasons of the preference for utilising TBA care. Improving health system cultural sensitiveness and strengthening partnership between formal health workers and TBAs have potential to enhance maternal health in both countries.