By Brenda Ninsiima
The Sustainable Development Goals (SDGs) represent a global commitment to end poverty, protect the planet, and ensure prosperity for all by 2030. Among these goals, SDG 3 focuses on ensuring healthy lives and promoting well-being for all at all ages. Specifically, target 3.1 aims to reduce the global maternal mortality ratio to less than 70 per 100,000 live births, while target 3.2 seeks to end preventable deaths of newborns and children under five years of age. In Uganda, traditional birth attendants (TBAs) play a crucial role in achieving these targets, particularly in rural communities where access to formal healthcare services is limited.
In Uganda, where approximately 70% of the population lives in rural areas, TBAs have long been integral to maternal healthcare. These community-based health workers, often women themselves, are usually chosen by their communities based on their experience, knowledge, and interpersonal skills. They provide essential services such as antenatal care, delivery assistance, and postnatal care. TBAs are often the first point of contact for pregnant women, especially in areas where healthcare facilities are distant or non-existent.
For instance, a study conducted in the Mbarara district found that TBAs provided a safe delivery option for over 60% of pregnant women in their communities, significantly reducing the barriers to accessing healthcare (Sserunjogi et al., 2020). Through their services, TBAs help to ensure that expectant mothers receive timely care and guidance throughout their pregnancy, which is critical in reducing maternal mortality rates.
Improving Child Survival Rates
TBAs also play a pivotal role in improving the survival rates of newborns and young children. They offer essential newborn care, educate mothers about infant health, and assist in recognizing danger signs that require referral to health facilities. For example, in the Kanungu district, TBAs are trained to conduct simple neonatal assessments and provide advice on breastfeeding practices, immunization schedules, and hygiene, which are essential for a child’s health and survival.
Moreover, TBAs often work closely with local health facilities to ensure that pregnant women are referred for more advanced care when complications arise. In a report from the Ministry of Health, it was noted that TBAs facilitated referrals for approximately 40% of the high-risk pregnancies they encountered, leading to better health outcomes for both mothers and infants (Ministry of Health, 2022).
Bridging the Gap in Healthcare Access
The significance of TBAs in Uganda extends beyond direct maternal and child health care; they act as a bridge between the community and formal health services. They help to raise awareness about available health services, including antenatal clinics, vaccination programs, and family planning resources. TBAs often mobilize community members to seek health services, thereby increasing the utilization of health facilities.
A practical example is the “Safe Motherhood” initiative launched in Uganda, which integrates TBAs into the national health system. The initiative includes training programs aimed at equipping TBAs with skills in basic emergency obstetric care, thereby enhancing their effectiveness. The program has led to a marked decrease in home births and a significant increase in institutional deliveries (UNICEF Uganda, 2021).
Challenges and the Way Forward
Despite their contributions, TBAs face numerous challenges, including limited training, inadequate support from health systems, and occasional stigma from formal health workers. To fully leverage the potential of TBAs in achieving SDG 3, it is essential for the Ugandan government and health policymakers to recognize and formalize their role within the health system. This could involve regular training, integration of TBAs into the healthcare system, and improving their access to resources.
Additionally, community awareness campaigns can enhance the understanding of the importance of seeking skilled healthcare and encourage collaboration between TBAs and formal health workers.
In conclusion, traditional birth attendants in Uganda play a vital role in achieving SDG 3 by reducing maternal mortality and improving child survival rates. Their intimate understanding of the local context and the trust they build within communities position them as indispensable health care providers, particularly in rural areas. By recognizing and strengthening the role of TBAs, Uganda can take significant strides toward improving maternal and child health outcomes, thereby contributing to the broader goals of sustainable development.
References
– Ministry of Health. (2022). Annual Health Sector Performance Report.
– Sserunjogi, S., Mugisha, J., & Matovu, J. (2020). The Impact of Traditional Birth Attendants on Maternal Health in Rural Uganda.
– UNICEF Uganda. (2021). The Role of Community Health Workers in Promoting Safe Motherhood in Uganda.
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