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

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.