• Lynn Sibley CNM, PhD,

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      Lynn Sibley, CNM, PhD, 1327 Peachtree St, NE, #504, Atlanta, GA 30309.
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    • Lynn Sibley is a Senior Technical Advisor for the Special Projects Section of the American College of Nurse Midwives working on the USAID funded PRIME Project. She is also an Adjunct Assistant Professor of Anthropology at Emory University in Atlanta, Georgia. She was on the faculty of the University of Colorado Nurse-Midwifery Graduate Program from 1981 to 1985 and earned her doctorate in anthropology from the University of Colorado in 1993. Dr. Sibley documented the work of practicing traditional birth attendants (TBAs) in Belize during 1989 to 1991. Her research focused on the relationship among TBA training, knowledge and practices, and their influence on maternal health.

  • Deborah Armbruster CNM, MPH

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    • Deborah Armbruster is Director of the Special Projects Section of the American College of Nurse Midwives in Washington, DC. She began her work with TBAs as a Peace Corps volunteer in Liberia in 1979 and, subsequently, provided technical assistance for national TBA programs in six sub-Saharan African countries, including Ghana, Nigeria, Gambia, Burkina Faso, Ivory Coast, and Uganda from 1986 to 1996. Ms. Armbruster's technical assistance activities have included TBA program development, implementation and evaluation, as well as supervision and operations research.

Lynn Sibley, CNM, PhD, 1327 Peachtree St, NE, #504, Atlanta, GA 30309.


The unacceptably high levels of maternal mortality that are prevalent throughout the developing world are a product of many factors; most notably, these include nonexistent, inaccessible or inadequate facility-based emergency care, poorly developed referral linkages, predominance of home-based care by attendants and family members who are poorly equipped to respond to emergencies, and the complexities of problem recognition and decision making during emergencies leading to inappropriate or delayed action. This paper describes an innovative community-oriented strategy that has been designed to reduce maternal mortality and that targets women, families, and traditional birth attendants (TBAs) using two complimentary training interventions. The strategy reflects the authors' conviction that the training of professional and paraprofessional health workers in emergency care is essential, but that it must be complemented by the education and mobilization of families, communities, and TBAs who must, in turn, come to common perceptions on the need for and means of intervening to prevent a maternal death. Collaborating with partners in the US Agency for international Development-funded Primary Providers Training and Education in Reproductive Health Project, Special Project staff of the American College of Nurse-Midwives will lead development and testing of the strategy through operations research activities in selected countries.