Traditional Birth Attendants Advocate for Facility-Based Deliveries

Along a dusty road speckled by orange trees, at the end of Soroti district in Eastern Uganda, lies Oderai village. As a resident says, “Our meals are planned: one may be able to have breakfast and struggle to get lunch.” Affording health care, let alone at a private facility, is impossible for most.

To address this challenge, Abt Global, in partnership with USAID, is implementing the USAID Uganda Voucher Plus Activity. The program aims to increase safe pregnancies and deliveries by collaborating with the private sector to provide vouchers for quality maternal and newborn health services to women who cannot afford the fees. To develop a sustainable private health care system for maternal and newborn babies in Uganda, we’re working with traditional birth attendants to build new relationships between patients and private health facilities.

“I grew up watching my grandmother deliver babies at home and learned a number of things,” says Joyce Mary Alaro, a traditional birth attendant. “I have delivered several [babies] successfully but some situations have been life threatening.”

With no specialized equipment to handle complicated cases, and the conviction that private health facilities give better and faster attention to mothers, Alaro now encourages mothers to go to the health facility where they can use their vouchers.

“[With the vouchers], this is a very affordable option for the many mothers that come to me,” she says. “What I want is to see a mother and her baby return home safely and happy, and the voucher offers that.”

Alaro connects all the mothers who come to her with the local Voucher Community Based Distributor and says that she has not delivered any children since USAID partnered with private facilities in the district.  

 “I went to ‘mama’ when I realized I had missed my period,” says Gorreti Apolot, a mother who’s used the voucher. “She told me right away to contact a community distributor, who came [to my] home and sold me a voucher and explained the services I will receive. I went to Teso Safe Motherhood, where I attended all four antenatal visits, delivered at the facility and went back after six days to make sure everything was okay with me and the baby.”

The partnership between Abt, USAID and private health facilities is a dream come true for Helda Auma, who became a Voucher Community Based Distributor in her community after delivering more than 100 babies on her own. “I wanted to use my own experience to sensitize the people in my community,” Auma says. To date, she has sold 381 vouchers to pregnant women and regularly follows up with the women to ensure they go to the health facility for antenatal, delivery, and post-natal care.

“I feel satisfied because I’m still serving the community and saving lives,” says Auma. “When pregnant mothers deliver they return to my home to show me the babies; this is fulfilling.”

Working with partners like Alaro and Auma, the activity is promoting safe pregnancies and safe deliveries through the private sector by working in 35 districts in northern and eastern Uganda.

Learn more about our work in Uganda.