Theses and Dissertations

Date of Award

2024

Document Type

Dissertation - NSU Access Only

Degree Name

Doctor of Education (EdD)

Department

Abraham S. Fischler College of Education and School of Criminal Justice

Advisor

Mary A. Clisbee

Committee Member

Hardwick Smith Johnson, Jr.

Keywords

Healthcare, medical assistants, qualitative research, phenomenology

Abstract

The problem that was addressed in this study was women in rural Haiti lack access to obstetrical care. The purpose of this study was to investigate the lived experiences of traditional birth attendants (TBAs) in rural Haiti, their needs as critical healthcare providers, and their perceptions of issues that require attention within their communities.

The investigator employed a qualitative, phenomenological study research design to develop a better understanding of the lives of TBAs in the current healthcare system in Haiti (Creswell & Creswell, 2018). A hermeneutic phenomenology research design, employing the photovoice technique, was used to gain an in-depth understanding of the lived experiences of TBAs and what they meant to the overall health system in rural Haiti (Laverty, 2003; Manen, 2015; Neubauer et al., 2019).

In this study, the TBAs and their lived experiences were the targets of investigation, and the primary objective of the study was to understand the role that TBAs play in the Haitian maternal health system. The individual TBAs who were approached to participate were identified by initially contacting local leaders and local stakeholders to identify TBAs who work with reproductive-age women. The TBAs were the sole group for evaluation, and this group included traditional healthcare workers working with women in Saint Michel de l’Atalaye’s rural communities. The five emerging themes include:

1. TBAs have multiple responsibilities within the community that extend beyond caring for women.

2. As trusted leaders in the community, TBAs are critical resources for improving maternal health in rural communities.

3. There is a limited system in place for the exchange of resources between formal and informal maternal healthcare.

4. There is a stark need for recognition that TBAs use natural medicines and have faith-based healing techniques that may or may not be evidence-based.

5. Women continue to experience challenges that, although acknowledged by the formal health system, have but have not improved over time.

Healthcare is difficult to access in developing country systems. This is especially so in rural communities where pregnant women must travel for hours on difficult terrain to find maternal care. Often, their only alternative means of care are the TBAs. Yet, TBAs do not have the tools to meet women’s maternal healthcare needs. The goal of this study was to bring TBAs’ views and perceptions to light via a thematic study using photovoice. Based on the themes developed from this study, we propose five recommendations to improve women’s maternal health issues in rural communities of LMICs.

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