Mapping Evidence on the Frameworks that Integrate Traditional Birth Attendants into Formal Health Systems in Low-Middle Income Countries: A Scoping Review

Background: In many countries, traditional birth attendants (TBAs) function independently from the formal health system and thus their practice is often unregulated. The paucity of data and lack of institutionalised feedback between TBAs and Healthcare providers (HCPs) may hinder safe maternal and newborn healthcare practices. Objective: This scoping review explored studies that have been published of frameworks that integrate TBAs into formal health system in low-and-middle income countries (LMICs). Method: Utilising the 2022 Joanna Briggs Institute (JBI) methodology for scoping reviews; the search strategy yielded 243 peer reviewed articles that were published between 2014-2024. Only 11 articles met the inclusion criteria and were thus included in the final review. Result: The review found that integrative frameworks are built on the need to improve maternal and newborn care rendered by TBAs and secondly, the need to empower community-based maternity care facilitated by TBAs is underscored. Conclusion: Although, TBAs fill the gap by rendering assistance to pregnant women and newborns in LMICs the lack of collaborative frameworks and implementation thereof requires intentional institutionalisation especially in areas where homebirths are still prioritised. Unique contribution: This scoping review maps the evidence of existing frameworks that integrate TBAs into formal health systems in LMICs which aimed at narrowing the communication gap between TBAs and formal HCPs. Key recommendation: There is a need for LMICs to explore modifying and implementing the frameworks presented herein to improve the care provided to women and babies.