Department of Obstetrics & Gynaecology
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Item ‘They treat you like their own’ perspectives and lived experiences of postpartum women seeking health services from traditional birth attendants (TBAs) in Mayuge district east central Uganda.(Research Square, 2025) Kagoya, Enid Kawala; Auma, Proscovia; Mugabi, Joshua; Kawala, Elizabeth; Asabawebwa, Deogratias; Mugahi, Richard; Mutunda, Brenda Doreen; Twineamatsiko, Andrew; Kabene, Mercy Jackline; Frank, Kayemba; Waako, Paul; Mugabe, Kenneth; Akello, JacklineBackground In Uganda, despite ongoing efforts to promote skilled birth attendance, many women in rural communities continue to deliver with Traditional Birth Attendants (TBAs). Understanding the reasons behind this preference and the nature of care provided by TBAs is critical for informing maternal health policy and community-level interventions. Objective To explore the experiences, perceptions, and underlying factors influencing the continued use of TBAs for childbirth among postpartum women in Mayuge District, Eastern Uganda. Methods A descriptive qualitative study was conducted in Mayuge District. In-depth interviews were held with 12 postpartum women who had delivered with TBAs within the past six months. Participants were purposively selected to capture variation in age, parity, and location. Data were collected using a semi structured interview guide, audio-recorded, transcribed verbatim, and translated into English. Thematic analysis was conducted using both inductive and deductive coding in NVivo 13. Results Five overarching themes emerged: (1) Health System Barriers, including poor access to health facilities, transport challenges, and mistreatment by health workers; (2) Perceived Benefits of TBA Care, such as affordability, emotional support, privacy, and flexible payment options; (3) Traditional Practices and Beliefs, with participants emphasizing cultural alignment, spiritual care, and birth rituals provided by TBAs; (4) Health Risks and Limits of TBA Care, reflecting awareness of complications, delayed referrals, and lack of emergency support; and (5) Community Influence, where social norms, peer recommendations, and collective trust in TBAs shaped decision-making. A cross-cutting theme of husband and family involvement also significantly influenced birth location choices. Conclusion The continued reliance on TBAs is shaped by a complex interplay of structural barriers, cultural values, perceived advantages, and community dynamics. Interventions to improve maternal health in rural Uganda should address health system gaps, promote respectful and culturally sensitive facility-based care, and engage families and communities in birth preparedness efforts. Keywords: Traditional Birth Attendants, Postpartum Women, Maternal Health, Uganda, Qualitative Study, Health-Seeking Behavior, Cultural Beliefs, Health System Barriers, Community Influence.Item Factors associated with longer hospital stay following caesarean section birth at a tertiary hospital in Eastern Uganda.(Research Square, 2025) Thaddeus, Jude Mulowooza; Tweheyo, Ronald; Babuya, Jonathan; Atuhairwe, Irene; Makoko, Brian Tonny; Waako, Paul; Twineamatsiko, Andrew; Agaba, Brian; Stephen, Obbo; Kavuma, Pontian Kiwanuka; Kibuule, Dan; Kayemba, Frank; Kagoya, Enid KawalaBackground. Caesarean Section(C/S) is a lifesaving procedure for both the mother and the baby but it is associated with various post-operative complications and longer hospital stays. Prolonged Hospitalization after a Caesarean section can be stressful for both the healthcare providers and the mothers while also risking them acquiring hospital acquired infections. Factors related to longer hospital stays among mothers delivered by C/S have not been well explored. This study aimed to determine the factors associated with longer (> 4 days) hospital stay following Caesarean birth at Mbale Regional Referral Hospital. Methods This was a retrospective cross-sectional study carried out at Mbale Regional Referral Hospital (MRRH) between December 2023 and May 2024 accessed in June 2024. A total of 536 patient files of women who underwent Caesarean section were randomly selected and reviewed. Data on social demographics, obstetric characteristics and other surgical details including outcomes was extracted and recorded using an online data collection tool. Descriptive analysis to summarise the data and logistic regression to identify factors associated with longer hospital stays were done, and P-values < 0.05 significance level at a 95% confidence interval were considered. Results The mean hospital stay was 4.02 days (SD ± 2.87). Nearly half of the women (47.6%) were referred from other health facilities with most caesarean sections (70.9%) sanctioned by junior house officers. Preoperative prophylactic antibiotics were administered in 85.4% and spinal anaesthesia was used in 98.5% of the Csections. In multivariable analysis, lack of a complete blood count, vaginal preparation, intravenous fluids before surgery and a patient undergoing general anesthesia were significantly related to longer hospital stays. Conclusion Multiple factors are associated with longer hospital stays at Mbale Regional Referral Hospital. Improvement of evidence-based practices such as the intravenous fluids, vaginal preparation and basic laboratory investigations before surgery and use of spinal anesthesia can help to reduce hospital stay and its associated risks. Keywords: Caesarean section, longer hospital stay, postoperative complicationsItem 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, KennethBackground: 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 ugandaItem Namayumba health centre overwhelmed with expectant mothers.(New Vision, 2018-05-24) Nabantazi, VioletNamayumba Health Centre IV in Wakiso district is overwhelmed with the number of expectant mothers. Over 100 mother deliver from the facility every month, yet it is meant for only 20 mothers.Item Buliisa, Hoima men shun antenatal visits(New Vision, 2018-06-08) Atuhairwe, RobertHealth officials in the districts of Buliisa and Hoima have expressed concern over the failure by men to accompany their expectant wives to health facilities for antenatal care services.Item Only 40% of children get proper medication - report(Sunday Vision, 2017-07-30) Masaba, JohnUganda's campaign to cut back on mortality figures of children under five years could be under threat, after a new study conducted on health facilities in the country showed that less than half of the children who visit hospitals get proper medical attention.Item Jinja porter aids neglected mother to give birth(New Vision, 2017-07-31) Nambogga, JackieThe Jinja district chairperson has instructed the Chief Administration Officer (CAO), Olive Nakyanzi together with the District Health Officer (DHO), Dyogo Nantamu, to probe a health officer who allegedly neglected a mother in labour. According to Titus Kisambira, the mother was instead aided by a porter to give birth.Item Row erupts between hospital and dead woman's family(New Vision, 2018-05-17) Kasujja, CarolRow has erupted between the family of the late journalist Nuliat Nambazira and the International Hospital Kampala (IHK) over her death. Nambazira, 38, passed on two weeks ago as a result of child birth-related uncontrolled bleeding. Her husband Abbas Semujju, told mourners that the hospital mishandled her leading to her death.Item Maternity leave not a favour, government tells private employers(New Vision, 2018-05-01) Kasujja, CarolAs Uganda joins the rest of the world in commemorating International Labour Day today, the Ministry of Labour, Gender and social Development has instructed all private companies to grant mothers paid maternity leave.Item Lango region women lack access to maternal healthcare services(Daily Monitor, 2017-10-11) Oketch, BillMost of the women in Lango sub-region are complaining of harsh treatment at health centres, while a few mothers claim they are often left to deliver on their own.Item Mayuge decry low access to maternal services(New Vision, 2017-08-02) Angatai, BettyNineteen-year-old Annet Namuwaya, a mother of one, lost her baby when she delivered at home. she could have saved the baby, had she delivered at a health facility.Item Wekebere device helps monitor your unborn child(Sunday Vision, 2017-07-30) Muto, AhmadMaternal and Neonatal health are of great concern, especially in hard-to-reach areas, where there is little or no access to quality antenatal services. However, with the advancement in technology, steps are being take to make those services more available through innovation.Item Parents tipped on preventing fistula(New Vision, 2018-05-21) Nantambi, Agnes; Kyotalengerire, AgnesDr Jackson Amone, the commissioner for curative services at the health ministry has advised parents to keep their girls in schools as a means of preventing fistula. " We need to prevent obstetric fistula by sensitising young girls to stay in schools, avoid early marriages and produce at the right age," said Amone.Item What you eat during pregnancy(New Vision, 2017-07-31) Kyotalengerire, AgnesMy husband always encouraged me to eat enough when we were expecting our second baby. Every evening he would return with bags full of milk, eggs, tins of yogurt and fruits such as Bananas, avocado. He encouraged me to eat saying it would keep me healthy and strong recounts Maria Twesigye, a month of two, who runs a bakery in Kampala.Item Fistula: What Uganda needs to end the condition(New Vision, 2018-05-23) Kyotalengerire, AgnesToday Uganda joins the rest of the world to commemorate the international Fistula Day under theme: End Fistula now, reach everyone. The commemoration aims at raising awareness, visibility of obstetric fistula and intensifying actions towards ending the condition in Uganda and the world over. Agnes Kyotalengerire explores what the Government is doing to eliminate thee backlog of 75,000 to 100,000 patients who are not treated.Item Pre-eclampsia: A major cause of maternal deaths(New Vision, 2018-05-21) Kyotalengerire, AgnesTomorrow is World Pre-eclampsia Day, which will be commemorated under the theme: "Ending Pre-eclampsia". Ahead of the day, Agnes Kyotalengerire explores how the condition can impact on the lives of mothers and their babies.Item Family planning: Empowering women to be productive(New Vision, 2017-07-11) Kyotalengerire, AgnesA woman who is informed about Family planning will decide on which method to use, to enable her produce the number of children she can take care of.Item Unmet need for family planning aggravates poverty(New Vision, 2017-07-10) Kyotalengerire, AgnesAccess to family planning key to empowerment, Development.Item The power of breast milk(New Vision, 2017-08-01) Kyotalengerire, AgnesImmediately after child birth, the midwife encouraged me to breastfeed. She emphasised that i should exclusively breastfeed. This is feeding the baby on breast milk only until they are six month old.Item Universal Health coverage still a pipe dream(New Vision, 2018-04-09) Nakajubi, GloriaFor the last 18 years in Luweero district where the World Health Day 2018 was commemorated on Saturday, 25,000 people have been enrolled in community health saving schemes.