An Open Conversation with Traditional Birth Attendants in Rural Uganda: The Potential for Collaborative Care

Abstract

An open conversation with traditional birth attendants in rural Uganda: The potential for collaborative care. J Glob Radiol. 2017;3(1):Article 3. Background: Imaging the World-Africa (ITWA) is a registered non-governmental organization aimed at distributing low-cost ultrasound services at health centers in rural Uganda. Yet, studies demonstrate that the majority of mothers continue to deliver with unregulated traditional birth attendants (TBAs) in their local villages. It has been suggested that the unregulated practices of TBAs has contributed to the high rate of maternal and fetal mortality. A greater understanding of the roles of TBAs in the manage-ment of pregnancy and delivery is needed. Purpose: The purpose of this report is to provide the international community with a greater under-standing of TBA practices as well as an assessment of their willingness for future collaboration. Methods: Three TBAs from diierent nearby villages attended a meeting with ITWA in Kamuli District, Uganda. The meeting included an interview and an educational session. A test on the management principles of common obstetric complications was administered at the beginning and end of the meeting to assess baseline knowledge and the eeect of the interaction. Results: The meeting with the TBAs provided valuable qualitative information about TBA clinical experience, the value of TBAs to the community and TBA understanding of ultrasound. On the pre-educational test, the TBAs had a limited understanding of pregnancy complications and condi-tions in which it would be safer for a mother to deliver at a hospital. After the educational session, the TBAs performed statistically signiicantly better on the post-test (p=0.03). Conclusion: The open conversation with the TBAs provided valuable information on the current role of TBAs in rural Uganda. Our experience with the TBAs demonstrates that TBAs are willing to engage with trained healthcare providers. Collaboration between TBAs and health centers in Uganda has the potential to bring to light previously unknown barriers and create solutions to better maternal and fetal care.