Birthing Choices among the Sabiny of Uganda

The paper analyses the realities of maternal health seeking-behaviour among the Sabiny in relation to health policy ideals. It is based on a study of maternal health among the Sabiny, Eastern Uganda that was conducted in 2011 and 2012. Secondary quantitative data were analysed and primary data were collected using in-depth interviews with mothers; focus group discussions with mothers and fathers; key informant interviews, and observation of delivery settings (both at health facilities and home). Findings reveal that the majority of Sabiny women opt for homebirths, with around a quarter delivering at health facilities. Some women would prefer to deliver at a health facility but do not manage to do so. Sabiny culture is a determining factor in delivery setting. Comprehension and accommodation of Sabiny concerns within available maternal health services is limited, highlighting the need to develop cultural competence among health workers and methods of accommodating (health-promoting) local practices. This should be accompanied by improved patient care and a narrowing of the gap between health workers and Sabiny communities by revitalizing outreach and community-based health interventions. The paper highlights how the implementation of policy should be tailored to specific local contexts.