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The paper focuses on the situational analysis of traditional birth attendants (TBAs) and skilled birth attendants (SBAs) in Zimbabwe. Against a background of a frail health care system, characterised by a shortage in skilled professionals, increased cost of medical care, and geographic and economic inaccessibility of health care centres among others, TBAs have remained a life-line for especially many rural women in maternal health care provision. Moreover, TBAs have also found their way into the urban areas of Zimbabwe. The shift in international policy and health funding toward skilled birth attendants (i.e., an accredited health professional) has materialized into concerted government efforts to increase numbers of both midwifery training institutions and midwives themselves. The call for SBAs, though a worthy ideal, is out of touch with the lived realities of pregnant women in low resource settings such as Zimbabwe. The study is concerned with situational analysis of TBAs and SBAs in maternal health care service provision in Zimbabwe analysing and evaluating policy considerations.

This paper analyses the importance of the services rendered by traditional birth attendants (TBAs) to pregnant women in Zimbabwe. It argues that, though an integral part of the health system, the ambivalence in terms of policy on the part of the government leaves them in a predicament. Sociocultural values as well as tradition imbue TBAs power and authority to manage pregnancies and assist in child deliveries. On the other hand, government policies expounded through the Ministry of Health (MoH) programs and policies appear to be relegating them to the fringes of healthcare provision. However, in a country with a failing health system characterized by mass exodus of qualified personnel, availability of drugs, and understaffing of healthcare centres, among others, TBAs remain the lifeline for many women in the country. Instead of sidelining them in healthcare interventions, I argue that their integration, however, problematic and often noted to be with disastrous consequences for traditional medicine, presents the sole viable solution towards achieving MDGs 4 and 5. The government and MoH should capitalize on the availability of and standing working relations of TBAs with the grassroots for better/positive maternal health outcomes. In a country reeling with high maternal deaths, TBAs' status and position in society make them the best intervention tools.