Home Institution

DePaul University

Publication Date

Summer 2016

Program Name

Uganda: Development Studies


Maternal and child health has been noted as an international concern and issue. While access to maternal healthcare has improved in Uganda since 2000, maternal mortality rates have remained high in the country as of 2015. However, maternal and child healthcare are inherently important in promoting sustainable and positive development. For that reason, I have explored maternal healthcare in Uganda’s Eastern region, specifically in Mbale Town and surrounding rural areas including Kween and Manafwa districts. Specifically I have looked at what factors influence women’s decision to give birth in a health centre or hospital, versus at home. I have also looked at what factors are contributing to high maternal mortality rates and what can be done to combat this issue. Throughout this study I have used a variety of qualitative ethnographic methods including participant observation, in-depth one-on-one interviews, as well as focus groups to explore why women choose to give birth in a health centre or hospital with a biomedical midwife, or with a Traditional Birth Attendant (TBA). Midwives are trained and their certification is nationally accepted while TBA’s may have not received any professional training and are not necessarily recognized by the government. However, they play a highly important yet contested role in Uganda. Further I will look at what delays and boundaries are contributing to high maternal mortality rates and what interventions are being used and can be used by hospitals, health centres, TBAs and the government alike. In maternal health care, scholars and organizations alike often talk about the three delays. The first delay refers to a lapse in making the decision to receive care. The second delay refers to that of being unable to reach a health facility while the third delay refers to that of not receiving high quality, appropriate care. Throughout this study, I found that each of these delays were present and took form in a variety of ways in Mbale Town and the surrounding rural districts. I also discovered that despite these delays being present, mothers felt empowered by making the decision to give birth where they wanted whether it was in a health facility, or at home with a TBA. I also discovered that most biomedical health workers were aware of these delays and the many challenges they faced, and had deeply considered ways in which they and others can reduce the rates of maternal mortality. Finally, maternal health care is inherently important when considering the development of Uganda. When looking to implement solutions to reduce the three delays and improve maternal healthcare, it is important to approach this not only in terms of human development but also economic growth.


African Studies | Family Medicine | Health Policy | Maternal and Child Health | Nursing Midwifery | Obstetrics and Gynecology | Pediatrics | Women's Health


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