Browsing by Author "Gamubaka, Richard"

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    Catching babies, carrying traditions : the voices and practices of traditional birth attendants in Mayuge District, East central Uganda.
    (BMC, 2025) Kagoya, Enid Kawala; Auma, Proscovia; Mugabi, Joshua; Kawala, Elizabeth; Asabawebwa, Deogratias; Mugahi, Richard; Mutunda, Brenda Doreen; Gamubaka, Richard; Namaganda, Agnes; Nsubuga, Allan G.; Akello, Jackline; Waako, Paul; Mugabe, Kenneth
    Background: Traditional Birth Attendants (TBAs) continue to support maternal and newborn care in rural Uganda, particularly where access to formal health facilities is limited. Their roles are deeply embedded in local culture and community trust, yet national policies provide inconsistent guidance on their engagement within the formal health system. Objective: To explore the evolution, experiences, practices, challenges, and perceived support needs of TBAs in Mayuge District, and examine their interaction with formal health structures. Methods: A qualitative narrative study was conducted with 15 purposively selected TBAs from all sub-counties of Mayuge District. In-depth interviews lasting 60 to 90 min were held at participants’ homes or workplaces. Participants described and demonstrated their maternal care practices. Audio recordings were transcribed, translated, and analyzed thematically. Results: Seven key themes emerged from the study: (1) Historical Developments and Evolution of TBAs, highlighting diverse pathways into practice such as apprenticeship, family mentorship, formal Ministry of Health training, and community programs; (2) Practices, Methods, and Approaches, detailing TBAs’ provision of antenatal, delivery, and postnatal care, and management of maternal and newborn complications using both traditional and modern methods including newborn resuscitation; (3) Infection Prevention and Control, revealing variable use of personal protective equipment and inconsistent waste disposal practices constrained by limited resources; (4) Maternal and Perinatal Death Surveillance and Response (MPDSR) Process, illustrating TBAs’ limited participation in formal death notifications and reviews; (5) Referral Process, highlighting complex referral behaviors involving health facilities, fellow TBAs, and traditional healers; (6) Socio-Cultural Influences on TBA Services, encompassing the impact of poverty, gender roles, community trust, and cultural norms; and (7) Challenges in Providing Safe and Effective Care, including barriers such as negative attitudes from health workers, transport difficulties, competition, and lack of formal support. Conclusion: TBAs in Mayuge District play a vital role in culturally grounded maternal care but face numerous challenges due to limited formal integration and support. Strategies are needed to strengthen collaboration, provide targeted training, and clarify policy to improve maternal and newborn health outcomes in underserved areas. Keywords: Traditional birth attendants, Maternal and newborn health, Socio-cultural determinants, Referral practices, Health system integration, Rural uganda
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    Surgical success in severe mpox lesions : a case report from Pallisa general hospital, eastern Uganda.
    (World Journal of Research and Review, 2024) Gamubaka, Richard; Abingwa, Patrick; Bua, Emmanuel; Abeso, Jullian; Maiso, Fred
    Mpox (formerly known as monkeypox) is a zoonotic viral infection caused by the monkeypox virus, a member of the Ortho poxvirus genus, closely related to variola (smallpox) virus. While traditionally considered a mild illness in most cases, mpox can present severe complications, particularly in immunocompromised individuals or those with delayed medical intervention (1). The recent resurgence of mpox outbreaks in both endemic and non-endemic regions has heightened awareness of its clinical manifestations, which include fever, swollen lymph nodes, and a distinctive rash that can progress into painful, disfiguring lesions (2). In Uganda, particularly in rural areas such as Pallisa in Eastern Uganda, healthcare resources can be limited, complicating the effective management of severe cases. Severe mpox lesions may require interventions beyond supportive care, including surgical management, to address complications such as extensive tissue damage or secondary bacterial infections (3). While antiviral treatments like tecovirimat and intralesional cidofovir have shown promise in managing severe cases (1,2,3), they are often not readily available in resource-limited settings. Therefore, surgical techniques, though considered a last resort, may be an essential component of treatment in certain cases. This case report from Pallisa General Hospital explores the role of surgery in managing severe mpox lesions. It highlights the challenges faced in a low-resource setting and the potential outcomes of surgical interventions in such environments. The report aims to contribute valuable insights into the management of severe mpox lesions, considering both the limitations and potential successes of surgical approaches, and the growing need for effective treatment strategies in the face of emerging epidemics. Index Terms— Mpox lesions, zoonotic viral infection.