Description: The data set consists of 15 transcripts of interviews with traditional birth attendants.

All nine provinces were included in the study sample, however, no data were collected for TBAs in Eastern Cape and KwaZulu Natal, urban or rural, Limpopo, urban, North West rural, or Western Cape urban, as TBAs’ practice is not encouraged in many communities and finding willing participants was thus a challenge. Abstract: This project was conceived to investigate the functionality of the South African civil registration and vital statistics system, and to identify those shortcomings that undermine its effectiveness and accuracy in the surveillance of birth and death statistics relative to expectant mother, infants and children. Through a Gap analysis the challenges, bottlenecks and short circuits (the 'gaps') within the surveillance system that serve to compromise the efficiency and effectiveness of the system were identified.

The project's aim was to strengthen the existing surveillance strategies for monitoring maternal and child morbidity and mortality in South Africa. The objectives of the project were the following: assess the current surveillance system and strategies for monitoring maternal and child morbidity and mortality in order to identify gaps and challenges within the system; and to describe the availability and performance of maternal, obstetric and infant health care services.

The gap analysis included gathering information related to the functioning, challenges and efficiency of the surveillance system at all levels including communities and assessment of the availability and performance of the Civil Registration and Vital Statistics system (CRVS) and maternal and child health (MCH) services.

All nine provinces of South Africa were included in the gap analysis. A total of eighteen (18) districts, one urban and one rural per province participated in the gap analysis. The target population included Department of Home Affairs and Department of Health officials working in different components of the CRVS system and MCH respectively at community, facility, district, provincial and national level. It also included all community leaders (these included traditional leaders, community leaders and farm owner/representative), Traditional Birth Attendants (TBAs), community health workers and pregnant women.

Digital audio recording

Face-to-face interview

Focus group

Self-completion

TBAs (women assisting/who have assisted other women during childbirth) who work or live in the participating communities and were present at the time of the study and have agreed to participate and signed the consent form.

Sampling

Different sampling methods were used to select districts and participants for the different components of the project. The sampling methods used are discussed below.

Sampling of the districts

A total of 18 districts (9 rural and 9 urban) were selected. From each province one urban and one rural district were selected to be included in the surveillance. Convenient sampling approach was used to ensure that the selected urban district is the district that hosts the provincial offices and rural district to be the one furthest from the provincial capital. Within each district the following were included in the sample: villages, Department of Home Affairs (DHA) offices (district and local office), urban and informal areas. In total, 18 rural communities (9 rural villages and 9 farms); 18 rural district (local) DHA offices; 18 urban settlement (9 formal & 9 informal); 18 urban district (local) DHA offices were selected. These selected areas formed part of the gap analysis conducted at community level. Convenient sampling approach was used to ensure that the selected DHA offices within the sampled districts were servicing the selected village, farm, informal settlement and formal settlement in that particular district. The sampled villages formed part of the catchment area of the selected health facilities. That is, the health facilities of focus were treated together with their catchment areas as communities. Detailed sampling approaches used to select participants are discussed below.

Sampling for the discussions with TBAs or women who assisted other women during childbirth

As TBAs practice is not encouraged in many communities, finding TBAs who were willing to participate in the discussion was a challenge. Furthermore, these individuals are rarely explicitly identified as TBAs but women who assisted other women during birth. A snowballing sampling technique was used to sample TBAs since they are not easily identifiable in the community. Traditional leaders, farmers/farm caretakers and community leader were also instrumental in identifying TBAs and organizing meetings with them. All identified TBAs participated in the discussions on CRVS and MCH services in their respective communities.