UGANDA: TRADITIONAL BIRTH ATTENDANTS WORKING IN DILAPIDATED  MATERNITY WARD IN PADER DISTRICT.

Government has banned Traditional Birth Attendance (TBA), BUT, in Pader District over 100 works in dilapidated old structures in hygienic condition. The expectants mothers share Malaria words with new born babies.

PADER DISTRICT-UGANDA: twenty two Traditional Birth Attendants at Awere Health Centre III in dilemma in delivering babies, the dilapidated maternity ward of three rooms they called home to deliver new babies are in sorry state, without running water.

Awere health Centre III have embarked to use Traditional Birth Attendants to bring expectants mothers from their home to avoid delivering babies from the village to curve child mortality rates.

It was at 7.30PM local time on Wednesday January 5, 2022 when the Regional Bank Manager of DFCU arrived at Awere Health Centre III, Mr. Allan Kinyera who was in the company of Mr. Mwaka Calvin the Councilor Three Chairperson of Awere Sub County they were welcome with ululation to officially witness the opening of Savings And Credit Cooperative or Society (SACCO) UGX 2 million of the TBAs.

The government of Uganda banned traditional Birth Attendants from delivering babies in 2010 in the hope of improving maternal-and mortality rates in Uganda, but here in Pader District. Awere Health Centre III, more than 100 TBAs are still in practice, despites ubiquitous free prenatal care in government hospitals, the practice continues to be both widespread and popular.

Nighty Lawino, she dares cold night during the rainy season to walk a far distance to ensure that expectants mother reach Awere Health Centre III to deliver babies. And yet their working condition are mar, even the future of the babies which are delivery may contract more diseases.

‘’We walk in bad conditions to transport mothers who are seeking to deliver babies in the night to bring them to Awere Health Centre III. In a  day we always have about 10 more expectants to deliver, and yet we have only three beds, soon after the babies are delivered we take the new babies to Malaria ward and other wards that with diseases .

Other problems we get during the rainy season, you get the call to bring expectants mothers to the health centre, and you have to walk with her in the cold, sometimes she may fall down with you’’ Lawino explained.

She narrates they under  dangerous  condition; be  side that  we have dilapidated old buildings that worry us, it may collapse on us at any moment

Lawino is one of TBAs hail  from Bolo parish 7 kilometers away, while some of them  come from Laboye parish 8 kilometers far away to deliver babies.

Jacklyn Akello, the In-Charge-of the Health Centre III, also agreed with Lamino  says thet the T BAs who bring expectant they are part extension who help  Midwife and community in better health services like Village Health Teams

‘’ Look there we have a maternity ward which is in bad condition, we have presented our request to Pader Department of Health, but we have not got feedback.” Akello decries

She says they started SACCO as a supplement to support to T BAs  because the government does has put banned on  them. We have disbursed 2,245,000 shelling SACCO for TBAs and our staff who are working in the health centre, this enumeration to save our purpose

The In-Charge adds that the group ‘’Konye Keni’’ SACCO was  started in 2018 as part of support to them, we are using TBAs SACCO to lobby for funds from well-wishers who may be willing to support TBAs , both TBAs and 24 medical staff.

Ms. Akello calls for team work within the Traditional Birth Attendants.

‘’ I am very happy that Awere local government has recognized your work as traditional birth attendants, despite the fact that the TBAs was banned in 2010

She disclosed that two of  TBAs has been enrolled as  part of tjhe work force, ‘’

The In-Charge Health Centre, appeals to the government to build a modern maternity ward to support the overwhelming numbers of expectants mothers .

Sa6s according to  daily record the numbers of Out Patients who normally visits the  medical services, is about 70 patients

Mr. Calvin Mwaka 24 says TBAs are the backbone of Awere Health Centre III, because they transport expectants mothers to the health centre to help medical workers on their duty.

He supports the enrolment of Florence Oyella and Catherine Angwec to part of the work forces, because of their good performance they have been co-opted to the Midwife.

Mr. Mwaka says the Pader District Health Teams, in 2020 when the visited Awere Health Centre condemned the maternity ward, the District Health Teams advised us that the building should not be used, because of the sorry state; it may collapse at any time.

The Local Councilor Chairman Three says according to the budget framework for 2021/2022 Awere Health Centre III has been earmarked to benefit in the health sector programs.

‘’Although, the budget planned did not cover maternity ward, but we have UGX150 million for contraction of Cancer Clinic, we are going to used part of cancer clinic for maternity ward.’’ Mr. Odong reveals.

Mr. Allan Christopher Kinyera, the Regional BANK Manager DFCU gave UGX 200,000 the support to help Traditional Birth Attendants get registration.

‘’I grow up here in this Health Centre III, in 1995 my father who was the Chairman National Resistance Councilor because of insurgency this was our cradle of land.’’ Mr. Kinyera mooted.

He added that although the water crisis has hit these health centre, but, when we were here we used to have boreholes. But, since the Health Centre does not have running water, I have talked to Pader Water Engineer which is going to provide a motor roller machine to pump water from the borehole at Awere Sub County compound to give support to the maternity ward and the health centre.

There is a need to upgrade Awere Health Centre III to Health Centre IV, because the population cover areas is big, the people of Lapul Ocwida Sub County, Lunyiri Sub County and part of Odek Sub County area like Lamala parish and community of Aromo Wang-lobo in Omoro district  all come to get medical services here .

‘’ June 2021, Permanent Secretary Okidi and the late Paul Lokech through the Pader Forum invited me for a stakeholder meeting in Pader town, we discussed numbers of issues. upgrading Awere Health Centre III to become Health Centre IV. And also we have proposed to upgrade Awere Sub County to become Awere Ton board.’’ Mr. Kinyera noted.

Ms. Akot Beatrice Atim. The Sub County Chief says the Traditional Birth Attendants SACCO they have started to enrolled in Pader district with the support of AVSI six year ago together with Ms. Akello the In-Charge of Awere Health Centre III.

She reveals that the two of them have been deployed out to reach core areas, when she was Pader Health Centre III; she was also the Sub County.

‘’We are waiting for planned expansion of the town council and we shall present also our health sector planned.’’ Akot Atim observed.

Ms. Atim, says when the physical planned is out she will share approved plan with the Awere community living in Gulu and is diaspora, there are 150 sons and daughters of Awere community living in Gulu

Uganda is projected to have 75percent of all baby deliveries performed by skilled birth attendants by the end of 2020, but traditional birth attendants (TBAs)is an area where meeting that mark is hard to achieve.

p by ministry of health indicates that TBAs is still active in developing countries although not recognized as medical practitioners, they command a high medical standing and many families seek TBAs as health care providers

According to the Ministry of Health’s Reproductive Material New-born, Child and Addolacnt Health Sharpened Plan for Uganda 2016-2020 about 416,000 women annually are still not assisted by skilled birth attendants.

Like many developing countries Uganda has a high maternal mortality rate of 343 per 100,000 live births