Unifying social identity: community skilled birth attendant

Abstract

Homebirth is regarded as gold standard and the premier standard of birth possible. Community Skilled Birth Attendants (CSBA) received a six-month training in and out of class at skilled birth attendant (SBA) training institutes, approved by the Government of the peoples republic of Bangladesh. The trainees are involved in assisting the safe and clean delivery at home in rural Bangladesh. Many CSBA are engaged in Government and non-government organisations in relation to providing birth attendant services in rural Bangladesh. The intention of HNPP, BRAC is to increase the number of CSBA in order to achieve MDG 5. The study explored the process of social identification of CSBAs. The notion of social identity has delineated a comprehensive account of social relations in the theory of practice of Pierre Bourdieu. Moreover, social relations explained the process of social identification employing the concept of selfcategorisation and social categorisation. The study employed qualitative methods to explore the mechanisms of internal and social categorisation of CSBAs. The findings reveal that CSBAs are known as BRAC health cadres in the community. They are struggling to establish their identity as trained midwives in the community. Despite some challenges of their professions, CSBAs are respected as ‘dactar or nurse apa’ by the villages. Professional training on SBA enables them to generate income and social prestige. TBAs and village doctors create constraints to perform professional responsibilities of the CSBA in the community. On the other hand, the villagers are still bewildered about the terms as well as the roles and responsibilities of Shasthya Shebika (SS), Newborn Health Workers (NHWs), Shasthya Kormi (SK) and CSBA of HNPP, BRAC. They are confused whether health providers of BRAC are required paying for assisting homebirth. The villagers also perceive that assisting to homebirth is considered as social norm rather than professional duties. Moreover, the villagers hardly found the government service providers in this regard. Therefore, the study has outlined a number of recommendations for strengthening the profession of CSBAs of HNPP in BRAC.