迎接新生命,传承传统:乌干达中东部马尤盖区传统助产士的声音与实践

Catching Babies, Carrying Traditions: The voices and practices of Traditional Birth Attendants in Mayuge District, East Central Uganda.

作者信息

Kagoya Enid Kawala, Auma Proscovia, Nsubuga Allan G, Mugabi Joshua, Kawala Elizabeth, Asabawebwa Deogratias, Mugahi Richard, Mutunda Brenda, Gamubaka Richard, Namaganda Agnes, Akello Jackline, Waako Paul, Mugabe Kenneth

机构信息

Busitema University.

Ministry of Health.

出版信息

Res Sq. 2025 Apr 17:rs.3.rs-6378764. doi: 10.21203/rs.3.rs-6378764/v1.

Abstract

BACKGROUND

Traditional Birth Attendants (TBAs) have long played a critical role in maternal healthcare globally, particularly in rural regions of sub-Saharan Africa, including Uganda. These individuals, who often possess skills passed down through generations, provide essential maternal and neonatal care in areas with limited access to formal healthcare services. Despite their significant contributions, TBAs face challenges in managing obstetric complications and ensuring optimal maternal health outcomes due to the absence of formal medical training and limited access to resources.In Uganda, TBAs are both recognized and banned by different health policies, creating a complex dynamic within the healthcare system. National policies have called for the regulation of TBAs and their integration into the formal healthcare system, especially in rural areas like the Busoga region, where healthcare access is limited however, the integration process has been met with various challenges, including cultural resistance, lack of training, and insufficient resources. This study aims to explore the role of TBAs in the Busoga region of Uganda, assess their practices and training needs, and evaluate the existing policies that aim to integrate them into formal healthcare settings.

OBJECTIVES

To explore the role of TBAs in the Busoga region of Uganda, assess their practices and training needs, and evaluate the existing policies that aim to integrate them into formal healthcare settings.

METHODOLOGY

We conducted 15 key informant interviews with traditional birth attendants in all sub-counties of Mayuge District. Key informant interviews were conducted at their respective homes/service points. This included return demonstrations from the TBAs on how they practice and perform or execute their services. Each interview lasted over an hour and was audio recorded. All recordings were transcribed and reviewed by the principal investigator. Data was analyzed using thematic analysis.

RESULTS

Some of the themes generated included how they came into existence like through Modeling from parents, apprenticeship and through assisting existing medical practitioners; what entices mothers to come to them instead of going to the facilities, specialized conditions managed and how they manage them.

CONCLUSION

We noticed that TBA services in Mayuge district increase the risk of communities to have poor maternal and newborn health outcomes.

摘要

背景

传统接生员长期以来在全球孕产妇保健中发挥着关键作用,尤其是在撒哈拉以南非洲的农村地区,包括乌干达。这些人通常拥有代代相传的技能,在正规医疗服务获取有限的地区提供基本的孕产妇和新生儿护理。尽管他们做出了重大贡献,但由于缺乏正规医学培训和资源获取有限,传统接生员在处理产科并发症和确保最佳孕产妇健康结果方面面临挑战。在乌干达,不同的卫生政策对传统接生员既予以认可又加以禁止,这在医疗系统内形成了复杂的局面。国家政策呼吁对传统接生员进行规范并将其纳入正规医疗系统,特别是在像布索加地区这样医疗服务获取有限的农村地区。然而,整合过程面临各种挑战,包括文化阻力、缺乏培训和资源不足。本研究旨在探讨乌干达布索加地区传统接生员的作用,评估他们的做法和培训需求,并评估旨在将他们纳入正规医疗环境的现有政策。

目的

探讨乌干达布索加地区传统接生员的作用,评估他们的做法和培训需求,并评估旨在将他们纳入正规医疗环境的现有政策。

方法

我们对马尤盖区所有次县的传统接生员进行了15次关键信息人访谈。关键信息人访谈在他们各自的家中/服务点进行。这包括传统接生员对他们如何开展和执行服务的现场演示。每次访谈持续一个多小时并进行了录音。所有录音都由首席研究员转录和审核。数据采用主题分析法进行分析。

结果

产生的一些主题包括他们是如何产生的,比如通过向父母学习、学徒制以及协助现有的医生;是什么吸引母亲们来找他们而不是去医疗机构,他们处理的特殊情况以及如何处理这些情况。

结论

我们注意到,马尤盖区的传统接生员服务增加了社区孕产妇和新生儿健康状况不佳的风险。

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