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2. hrough the information gathering activities in (1) above,
address the following issues:
Are there areas that*BA's are less effective (by their own
admission or generally accepted)? Are TEA's relatively more
effective in some tasks..than other "health change agents" in
the ccmnmnity, ie. promoters, TSR's, pharmacists? Which health
tasks?
Can the TEA bridge the alleged "cultural barriers to acceptance
of health services" any more effectively than othewr health
workers? -
b. Competition: To what degree is there specialization among
traditional health practitioners in the Guatemalan cammnity in
terms of care of the newborn through the first year of life?
Does the degree of specialization reach a point of frank
ccirpetition? Would ccmpetition be the result if TBA's received
training on "care of the newborn and the infant?" Competition
with which "health change agents?"
c. Voluntarism: Is it reasonable to expect TBk' s to devote
significant amounts of time, outside of earning their fees for
assisting in the birth process, in providing assistance, advice
to mothers regarding the health of their newborn and infants?
d. Incentives: Would the TBA view referral of "high ris
births" to tuspital or health centers as a disincentive to
,participate in the MOH program, ie. lose a client to the formal
health system? Is there any reason to believe that TBA's would
accept MOH's assertion that the system would "counter refer"
normal deliveries from hospital to the TBA2M
3b Discuss the relative advantages and disadvantages (technical,
socio-economic, cognitive, geographic, etc.) of involving the
TBA in delivering some or all the child survival interventions,
including birth spacing, in Guatemala. (This discussion should
cite empirical data wherever possible.)