Historically, Traditional Birth Attendants (TBA) have operated outside of the formal healthcare delivery structure. TBA training has been used as a means of extending health services to underserved communities in developing nations in hopes of decreasing mortality and morbidity. While the focus in the past two decades has been on training TBAs, studies on training impact has shown conflicting results in maternal outcomes with many studies showing little to no impact on high maternal mortality outcomes. As a result, there has been a shift toward skilled birth attendants, capable of averting and managing complications.