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27% of Mothers Still Deliver in the Hands of TBAs in Gulu

Dr. Baifa Arwenyo attributed the maternal deaths to hypertension and hemorrhage, something she says can be managed with proper antenatal care, which most mothers haven’t embraced fully.
Midwives attending the Internatuional Day of Midwives on Wednsday at Gulu Regional Referral Hospital-Photo By Simon Wokorach

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At least 27 percent of the expectant mothers in Gulu district still give birth at the hands of Traditional Births Attendants-TBAs. Dr. Baifa Arwenyo, a Gynecologist at Gulu Regional Referral Hospital revealed this during the commemoration of the International Day of Midwives on Wednesday. 

Arwenyo explained that many of the expectant mothers still face the challenge of the long distance to the health facilities, which forces them to resort to TBAs, whose services were outlawed. She also revealed at 48 mothers died while giving birth at different health facilities in Gulu district between 2019 and 2020.

Dr. Baifa Arwenyo attributed the maternal deaths to hypertension and haemorrhage, something she says can be managed with proper antenatal care, which most mothers haven’t embraced fully.  

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Speaking at the same event, Beatrice Akello, the Principal Assistant Nursing Officer at Gulu Regional Referral Hospital noted with concern the shortage of midwives and poor working environment as one of the major challenges compromising maternal health service delivery.

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Dr. Florence Oyella, the Head of the Pediatric Ward at Gulu Regional Referral Hospital urged the government to invest in midwives if the Country is to improve maternal health services. Alice Akwero, 40, a mother of 9 children with a 2-month-old baby girl from Palaro Sub County is among the mothers who survived death while trying to deliver at home. 

Akwero disclosed that the nurses from a nearby health facility turned her away when she reported for delivery due to lack of personal equipment required for mothers at maternity.  Edisa Angom, 66, a TBA from Patiko Sub County, says that although she saved the lives of 70 through her services she decided to abandon the practice. According to Angoma, she receives at least 9 expectant mothers seeking her services but she refers them to different health facilities for skilled delivery.  


Dr. James Elima, the Gulu Regional Referral Hospital, who presided over the celebrations urged the medical workers to adhere to the medical profession ethic and serve diligently to avoid litigation. “You have the lives to save for, which you have been called to and it’s my prayers that you put aside your grievances as the government works toward your welfare,” Dr. Elima said.

The 2019 report from UNICEF shows that Uganda had reduced maternal deaths from 438 to 336 per 100,000 live births with 43 newborn deaths per 1,000 live births. The report further indicates that 7 midwives in Uganda currently attend to 1,000 mothers.  There are 147 midwives in Gulu district, 53 at Gulu Regional Referral Hospital, 40 at St. Mary’s Hospital Lacor and 54 at lower health facilities.