The Burden of Traditional Birth Attendants in East Africa

Since long before hospitals were in existence, women in East Africa having been giving birth with the assistance of caring and experienced women in their communities. These women are known as Traditional Birth Attendants (TBAs).  Often lacking in formal training, these birth attendants have derived their midwifery experience through years of sacrificial service. Along the way, they have become competent in educating women on how to care for themselves and their newborns. Recognizing their vital role in the health of East African women, Celesta Bargatze (a Childbirth Educator and Instructor in the Institute’s Childbirth Education Program) and I (a student in the program) have connected with local TBAs in East Africa.

I spent an afternoon last week with Kaari Annceta, a TBA in Embu, Kenya. Kaari is an elderly woman who began serving the women in her community as a birth attendant in 1958. Her life’s work began at the age of twenty-five, when she arrived at the home of a neighbor who was ready to give birth. Seeing that she was the only one who could help, she prepared herself to deliver the baby. She recalled, “I took courage, prepared a place, and caught the baby. The next day, word spread around the village that there was a new midwife.” She continued serving the women in her community until 2001, and still today educates the community on proper hygiene and nutrition. It is caring women like her who are a valuable resource to a developing community. My time with Kaari proved to be fruitful as I saw in her an example of courage and strength, while also gaining perspective on Kenya’s changing maternity system.

In Uganda, TBAs are still very active in the work of assisting women in childbirth. Recognizing their important role, Uganda has organized and registered its TBAs, offering them training to meet the demands for maternal healthcare and childbirth services. Celesta Bargatze, assisted by myself, led a meeting with TBAs local to Bombo Town, Uganda last Wednesday. The aim of this meeting was to create dialogue in the community regarding the need for birth attendants and the challenges that these women face in their work. It was also a time of education as a way to support these women’s work and increase their competency to serve.

The fifteen TBAs who came to the meeting were eager to dialogue about the many challenges they face, ranging from issues of women with major complications that were unaddressed by other health workers to lack of resources and payment.  While burdened with these challenges, the women were happy to serve childbearing women and were proud to say that they treat them with the utmost care and respect. Pray for our work in East Africa in the area of Childbirth Education as we seek to gain experience in this field so that we may address the challenges women in East Africa face, while bringing new life into the world.

By: Megan Fleeman