Knowledge, attitudes and practices of traditional birth attendants in the management of prolonged labour in Iganga District, Uganda

Abstract

Traditional Birth Attendants, with no knowledge on partograph, are some of the participants in the birthing process in many developing countries. They handle among other cases, prolonged labour which remains a significant cause of maternal and perinatal morbidity and mortality in poor countries. TBA Manual-Uganda,(1997) requires them to refer mothers with prolonged labour. Unfortunately a review of TBA training and utilization programs in more than 70 countries over the past 3 decades reveals that there are very limited examples of their successful utilization and therefore their impact on reduction of maternal mortality ratios is not significant. Millions of women get pregnancy related complications and hundreds of thousands die annually. Majority of these deaths are preventable. Iganga is one of the districts with poor maternal health indicators. Poor management of prolonged labour by TBAs partly contributes to maternal and perinatal morbidity and mortality. This study was done to describe the Knowledge, Attitudes and Practices of TBAs in the management of prolonged labour in Iganga District. Since no such study had been yet done, these findings hopefully might influence policy. General Objective: To describe the Knowledge, Attitudes and Practices of TBAs in management of prolonged labour in pregnant women in Iganga District, Uganda. Methods: This was a cross-sectional de scriptive study done among trained Traditional Birth Attendants in Iganga District Uganda. Consecutive sampling technique was used and data collected using Interviewer administered questionnaire and Key Informant Interviews. Data was entered and cleaned using EPI INFO version 2.1b and analyzed using SPSS version 12.0. Results: A sizable number of TBAs, (58.6%) were able to refer mothers with prolonged labour. Their Knowledge about prolonged labour however, is still poor (100%). Bad practices like administering herbs (90%), applying pressure on the abdomen (96.9%), are still common among the TBAs. All TBAs had a positive attitude towards management of prolonged labour. Conclusions: TBAs still have poor knowledge about prolonged labour despite training, majority still carry out harmful practices which might eventually lead to maternal mortality. They are willing to cooperate with skilled health workers. Recommendation: There is an urgent need by the Ministry of Health to bridge this gap in the maternal services which are currently provided by the TBAs if Uganda is to significantly reduce on its high maternal mortality rate.