Capacity Building for Traditional Birth Attendants to Deliver Integrated TB Screening and Triple Elimination Services among Pregnant Women in Riverine Communities of Bayelsa State, Nigeria
1
TB/HIV Services, Caritas Nigeria, Abuja, Federal Capital Territory, Nigeria
2
TB/HIV, Institute of Human Virology, Nigeria, Abuja, Federal Capital Territory, Nigeria
3
TB/HIV/Malaria, Global Fund, Geneva, Switzerland
Popul. Med. 2026;8(Supplement Supplement 1):
ABSTRACT
BACKGROUND:
Pregnant women accessing antenatal care through informal delivery settings remain underserved by facility-based TB screening and Triple Elimination of mother-to-child transmission (HIV, syphilis, and hepatitis B) services in Nigeria. Traditional Birth Attendants (TBAs) are often the first point of contact for pregnant women in riverine and hard-to-reach communities in Bayelsa State, presenting an opportunity to extend integrated screening services through task-shifting and capacity building.
METHODS:
An implementation research design was used to evaluate a capacity-building model that trained 120 traditional birth attendants (TBAs) and 58 community volunteers to deliver integrated TB symptom screening and Triple Elimination referral services for pregnant women aged ≥15 years across all eight local government areas of Bayelsa State. The intervention comprised a structured two-day training, provision of job aids and commodities, establishment of referral linkages to comprehensive treatment facilities, and quarterly supportive supervision. Pre- and post-training assessments measured knowledge, skills, and self-efficacy. Service delivery outcomes—including screening coverage, case detection, and linkage to care—were tracked from January to December 2025 using routine registers and analyzed descriptively in Microsoft Excel.
RESULTS:
Post-training assessments showed substantial capacity gains among community workers, with a 93% increase in knowledge of symptomatic TB and Triple Elimination services, an 85% improvement in rapid test kit utilization, and 81% reporting high confidence in integrated screening. The TBA-led integrated approach reached 51,795 pregnant women. TB screening identified 1,265 presumptive cases, all evaluated using GeneXpert with no confirmed TB diagnoses. Triple Elimination testing detected 42 HIV-positive and 4 syphilis-reactive cases, all linked to ART, while 42 EID samples yielded 13 positive infants successfully enrolled in care.
CONCLUSIONS:
Training TBAs and community teams effectively extends integrated TB screening and triple-elimination to informal settings. This strategy significantly accelerates progress toward eMTCT and TB elimination goals within underserved and unreached populations.
Pregnant women accessing antenatal care through informal delivery settings remain underserved by facility-based TB screening and Triple Elimination of mother-to-child transmission (HIV, syphilis, and hepatitis B) services in Nigeria. Traditional Birth Attendants (TBAs) are often the first point of contact for pregnant women in riverine and hard-to-reach communities in Bayelsa State, presenting an opportunity to extend integrated screening services through task-shifting and capacity building.
METHODS:
An implementation research design was used to evaluate a capacity-building model that trained 120 traditional birth attendants (TBAs) and 58 community volunteers to deliver integrated TB symptom screening and Triple Elimination referral services for pregnant women aged ≥15 years across all eight local government areas of Bayelsa State. The intervention comprised a structured two-day training, provision of job aids and commodities, establishment of referral linkages to comprehensive treatment facilities, and quarterly supportive supervision. Pre- and post-training assessments measured knowledge, skills, and self-efficacy. Service delivery outcomes—including screening coverage, case detection, and linkage to care—were tracked from January to December 2025 using routine registers and analyzed descriptively in Microsoft Excel.
RESULTS:
Post-training assessments showed substantial capacity gains among community workers, with a 93% increase in knowledge of symptomatic TB and Triple Elimination services, an 85% improvement in rapid test kit utilization, and 81% reporting high confidence in integrated screening. The TBA-led integrated approach reached 51,795 pregnant women. TB screening identified 1,265 presumptive cases, all evaluated using GeneXpert with no confirmed TB diagnoses. Triple Elimination testing detected 42 HIV-positive and 4 syphilis-reactive cases, all linked to ART, while 42 EID samples yielded 13 positive infants successfully enrolled in care.
CONCLUSIONS:
Training TBAs and community teams effectively extends integrated TB screening and triple-elimination to informal settings. This strategy significantly accelerates progress toward eMTCT and TB elimination goals within underserved and unreached populations.
| eISSN: | 2654-1459 |
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