Why Mbale expectant mothers opt for TBAs

On the night of November 15, Brenda Namakoye, a 27-year-old mother of three, died of excessive bleeding after delivering a baby.

She was reportedly being helped by a 61-year-old Traditional Birth Attendant (TBA) in Luyekhe Village, Mbale District. 

The deceased had been rushed to the TBA by her husband after she experienced labour pains. 

The late Namakoye is one of the many expectant mothers in Mbale who continue to opt to deliver at the hands of TBAs whose services were outlawed in 2010. 

TBAs are individuals, who use old-fashioned tools, skills, and knowledge to help women give birth. 
Ms Irene Nandutu, an expectant mother at Namanyonyi Health Centre III in Mbale City,  told Daily Monitor that lack of enough delivery beds in government facilities forces them to look for TBAs. 

“We always seek the assistance of a TBA because we are not ready to struggle for a bed at health facilities. Sometimes we deliver on the verandah,” she said. 

Ms Stella Nambalayo, a teacher, said many expectant mothers in rural areas cannot afford transport. 

“Every woman would wish to deliver at a health centre if it were accessible,” Ms Nambalayo, said. 

The mothers made the remarks while receiving two tricycle ambulances from the chairperson of Mbale City Land board, Mr Paul Wanyoto, and his wife, Rotarian Rebecca Wanyoto Nagidde, at Namanyonyi Health Centre III on Monday. 

The couple also donated tricycle ambulances to other government health facilities, including Buwalasi Health Centre III in Sironko District worth Shs32m. 

Mr Wanyoto said his dream is to see mothers access better healthcare.

“Rural areas need emergency services, especially when it comes to transporting expectant mothers,” he said. 

Mr Wanyoto, a Kampala-based High Court advocate, explained that by seeking services from TBAs, women risk their lives since there are high chances of contracting infections used during delivery.  

Ms Jalia Namasaba, who represented the Rotary Club of Mbale City, said the ambulances will enhance timely referrals for mothers. 

“It will check maternal and infant mortality rates,” she said. 

Ms Ruth Kakai, a retired teacher and resident of Buwalasi Sub-County, said the government should provide staff quarters for the midwives to enable them stay at the facilities. 

“‘The terrain in rural sub-counties is also bad. This poses a challenge of transporting patients to Mbale Regional Referral Hospital,’’ she said.

Some of the Village Health Team members in Mbale and the neighbouring districts attribute mother-to-child HIV transmission to TBAs. 

Mother-to-child transmission accounts for more than 95 percent of HIV/Aids infections in children under five, according to health officials. 

Ms Irene Kituyi, the assistant health officer-in-charge of maternal child health in Mbale City, said Namanyonyi facility is overwhelmed with a number of deliveries. 

“The facility delivers 60 mothers every month and some of the reported maternal deaths could have been saved if we had an emergency transport,’’ she said. 

Mr Steven Masiga, a researcher, said thousands of expectant mothers find TBA friendlier than medical workers. 
“Since TBA use the local languages, they bond quickly with mothers in labour. Mothers also shun hospitals because of upfront payments while TBAs ask for money after delivery ,” he said. 

Mr Jacob Gimungu, the in-charge Buwalasi Health Centre III, said they need an ambulance service to strengthen the response capacity. 

The government outlawed traditional birth attendants in 2010, arguing that they cannot handle haemorrhaging in women, which contributes to 42 percent of maternal deaths.