Paper short abstract:

This study will look into the practices of both traditional birth attendants and church birth attendants in Lagos and argue that while they have incorporated biomedicine due mainly to the state training programs, they should be considered as entrepreneurs who combine different practices for profits.

Paper long abstract:

In Lagos, the largest city in Nigeria, it looks as though the practices of both traditional birth attendants (TBA) and church birth attendants (CBA) are being integrated into the health delivery policy under the influence of biomedicine. The ministry of health in Lagos state has been providing the practitioners with training courses in which they learn the basics of obstetrics and hygiene and work as intern-nurses at general hospitals. This has led to considerable changes in their practices which may well be described as medicalization. However this does not mean that their overall practices are uniformly giving a way to biomedical paradigm.

The 'medicalization' of TBAs' practices can easily be observed, for instance, in their antenatal clinics where they regularly examine pregnant clients and send them to laboratory tests and their etiology in which they attribute miscarriage mainly to fibroid, Rh-blood type, and repeated abortion. Yet they are proud of using herbal medication for their clients. CBAs also have antenatal clinics and sometimes refer their patients to hospitals. But they employ spiritual healings which include prayer, holy water and fasting.

These hybrid practices are due partly to a market situation where these practitioners must attract clients by stressing the distinctive areas of their specialty as well as incorporating something new and global in order to make profit. In this respect, they are entrepreneurs who try to seize whatever chances they encounter, while maintaining trustworthy practices. Biomedicine appears to form one of such chances for them.