The Communication Initiative
Development action with informed and engaged societies
The Communication Initiative
After nearly 28 years, The Communication Initiative (The CI) Global is entering a new chapter. Following a period of transition, the global website has been transferred to the University of the Witwatersrand (Wits) in South Africa, where it will be administered by the Social and Behaviour Change Communication Division. Wits' commitment to social change and justice makes it a trusted steward for The CI's legacy and future.
 
Co-founder Victoria Martin is pleased to see this work continue under Wits' leadership. Victoria knows that co-founder Warren Feek (1953–2024) would have felt deep pride in The CI Global's Africa-led direction.
 
We honour the team and partners who sustained The CI for decades. Meanwhile, La Iniciativa de Comunicación (CILA) continues independently at cila.comminitcila.com and is linked with The CI Global site.
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The effect of traditional birth attendant training on maternal and neonatal care

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Miller, P. C., G. Rashida, et al. (2012). "The effect of traditional birth attendant training on maternal and neonatal care." Int J Gynaecol Obstet 117(2): 148-152.

OBJECTIVE: To determine whether traditional birth attendants (TBAs) trained via the "SMART Dai" method were superior to untrained TBAs in knowledge and practice regarding maternal and newborn care.

METHODS: In a cluster-randomized trial in the Dera Ghazi Khan District of Punjab, Pakistan, 120 rural communities each with a population of approximately 5000 were randomly assigned to a community-based intervention (CBI) or a health systems intervention (HSI). In the CBI communities, 288 TBAs underwent an innovative 8-day training course on maternal and newborn care, initially evaluated by pre- and post-tests. After an average of 19 months post-training, 277 TBAs, together with 257 comparably chosen untrained TBAs from the HSI communities, were tested and interviewed. Patients from both referred and non-referred deliveries were also interviewed.

RESULTS: Characteristics of TBAs in the two groups were similar. The TBAs were evaluated according to various measures of knowledge, skill, and practice (including referral), with patient reports on practice compared with TBA reports. By most measures, trained TBAs outperformed untrained ones, often to significant degrees.

CONCLUSION: SMART Dai training seemed to be an important factor in the significant reduction in perinatal mortality in the CBI areas. Properly trained TBAs can substantially contribute to improved delivery outcomes.