The system of traditional birth attendants in Senegal in 1971 is discussed. The country of Senegal has an inadequate health care system, with 254 doctors and 259 professional midwives for nearly 4 million inhabitants. Thus, there is a pressing need for traditional birth attendants in rural areas. These are generally illiterate women who are trained to assist in the birth process and in some cases give instruction on hygiene, nutrition, and child raising. Training consists of 8 days of classes and 3 weeks of practical experience. There are presently 8 rural maternity centers in Senegal, staffed by the traditional birth attendants and supervised by a nurse or professional midwife. The traditional birth attendants are compensated privately and sometimes work in teams. Their most important function is the practice and teaching of hygiene before, during, and after childbirth. Infant mortality decreased through this program from 70/million to 35/million births, attributable mainly to a decrease in neonatal tetanus. The centers suffer from a lack of supervision and, often, lack of public acceptance. It is now necessary to increase the number and scope of the maternity centers and traditional birth attendants to include other areas of pre- and post-natal care.