Will phasing out birth attendants reduce mortality?
Sep 10, 2009
THE health ministry has finally phased out the use of traditional birth attendants (TBAs), to reduce the reduction in maternal and child mortality. According to a circular sent to district health officers, health centres, partners and hospitals, this will
Simon Mugenyi
THE health ministry has finally phased out the use of traditional birth attendants (TBAs), to reduce the reduction in maternal and child mortality. According to a circular sent to district health officers, health centres, partners and hospitals, this will accelerate the reduction in maternal and child mortality.
The question is, will this move achieve its intended goal? One of the biggest challenges we have in Uganda is having good intentions, but using wrong means to get there.
Banning TBAs will not solve much.
In the circular the ministry acknowledges that stopping TBAs will ensure mothers are handled by skilled attendant (skilled staff, appropriate equipment, supplies and drugs).
This is true, but how prepared is the ministry to implement this. Many of our health centres are poorly staffed and equipped. How many health centre IIIs and IVs have operating theatres? In many places there are theatres, but they are non-operational. Even where there are midwives at these health units, they are not willing to care for an expectant mother in an emergency at any time of the day.
Some health workers are not bothered about mothers requiring emergency attention during day and it is worse at night. In contrast, most TBAs are willing to give them the care and attention they deserve.
Reason? Most TBAs are well-known people in their communities. That is why mothers are more comfortable delivering in the presence of a TBA.
The ministry acknowledges that there is a big unmet need for skilled attendance especially in hard-to-reach areas, a fact that often drives women to seek services from TBAs.
There is need to strengthen the health system. The Government should show commitment in doing this before implementing some of these policies. It has been noted before that only 12 of the 80 districts in Uganda have achieved the agreed staffing level of 80%. Only 38.4% of the proportion of approved posts are filled with health professionals.
Therefore, the Government needs to ensure that the required positions in our health units are filled. It should also construct more health units all over the country.
The writer is a communications specialist
THE health ministry has finally phased out the use of traditional birth attendants (TBAs), to reduce the reduction in maternal and child mortality. According to a circular sent to district health officers, health centres, partners and hospitals, this will accelerate the reduction in maternal and child mortality.
The question is, will this move achieve its intended goal? One of the biggest challenges we have in Uganda is having good intentions, but using wrong means to get there.
Banning TBAs will not solve much.
In the circular the ministry acknowledges that stopping TBAs will ensure mothers are handled by skilled attendant (skilled staff, appropriate equipment, supplies and drugs).
This is true, but how prepared is the ministry to implement this. Many of our health centres are poorly staffed and equipped. How many health centre IIIs and IVs have operating theatres? In many places there are theatres, but they are non-operational. Even where there are midwives at these health units, they are not willing to care for an expectant mother in an emergency at any time of the day.
Some health workers are not bothered about mothers requiring emergency attention during day and it is worse at night. In contrast, most TBAs are willing to give them the care and attention they deserve.
Reason? Most TBAs are well-known people in their communities. That is why mothers are more comfortable delivering in the presence of a TBA.
The ministry acknowledges that there is a big unmet need for skilled attendance especially in hard-to-reach areas, a fact that often drives women to seek services from TBAs.
There is need to strengthen the health system. The Government should show commitment in doing this before implementing some of these policies. It has been noted before that only 12 of the 80 districts in Uganda have achieved the agreed staffing level of 80%. Only 38.4% of the proportion of approved posts are filled with health professionals.
Therefore, the Government needs to ensure that the required positions in our health units are filled. It should also construct more health units all over the country.
The writer is a communications specialist