Introduction:Maternal autonomy regarding child birth, dependence on the husband

Introduction:Maternal health refers to the well-being of women during pregnancy, childbirth and the postpartum period according to WHO (World Health Organization), becoming a mother is often a positive and fulfilling experience, but for many women it is associated with suffering, ill-health and even death. The major direct causes of maternal morbidity and mortality include hemorrhage, infection, high blood pressure, unsafe abortion, and obstructed labor.About 830 women die from pregnancy or childbirth related complications around the world every day. It was estimated by WHO that in 2015, roughly 303 000 women died during and following pregnancy and childbirth. Almost all of these deaths occurred in low resource settings, and most could have been prevented. Between 1990 and 2015, the global maternal mortality ratio (the number of maternal deaths per 100 000 live births) declined by only 2.3% per year between 1990 and 2015. However, increased rates of accelerated decline in maternal mortality were observed from 2000 onwards. In some countries, annual declines in maternal mortality in 2000 to 2010 were above 5.5%.In Uganda, mothers are dying at an alarming and increasing rate. Uganda’s Maternal Mortality Rate (MMR) has consistently been one of the highest in the world with 440 deaths per 100,000 live births, according to Unicef’s latest data. In Uganda, one woman out of every 49 will die of a maternal complication related to pregnancy or delivery. According to Support opportunities for Ugandans to learn (S.O.U.L foundation) Women in rural Uganda face multiple barriers to accessing critical routine and lifesaving maternal health care. The barriers fall into the Three Delays Model: delay in deciding to seek care, delay in reaching care (e.g. transportation and lack of road infrastructure), and delay in receiving adequate and appropriate care (e.g. lack of skilled birth attendants).Uganda’s latest Demographic and Health Survey 2016 shows good news; maternal health indicators are improving. 95% of Ugandan women now receive antenatal care from a skilled provider at least once, 57% deliver babies in a health facility under the supervision of a skilled provider. Furthermore, 33% of the mothers received a postnatal check-up within two days of birth.Women in rural areas in Uganda have continuously preferred childbirth using traditional mothers for reasons being women’s lack of decision- making autonomy regarding child birth, dependence on the husband and other family members for the final decision, and various physical and socioeconomic barriers including long distances, lack of money for transport and the requirement to bring baby clothes (mama kit) and food while staying at the clinic, prevented them from delivering at a clinic. In addition, socio-cultural norms regarding childbirth, negative attitude towards the quality of services provided at the clinic, made most women deliver at home. Moreover, most women had a positive attitude towards TBAs and perceived them to be respectful, skilled, friendly, trustworthy, and available when they needed them. This has forced them to keep on using traditional birth attendants for child delivery which has put some of the pregnant mothers at risk because they are trusting people with little professional experienceGiven the deaths of women and children caused by traditional birth mothers experienced Uganda officially banned traditional birth attendants (TBAs) in 2010 but they have continued to practice. Eighty percent of rural women prefer TBAs to skilled attendants according to officials at the Ministry of Health, and 10% of number that is lost during child delivery was with TBAs.While the government’s focus in the past two decades was on training TBAs, studies on training impact have shown conflicting results in maternal outcomes with many studies showing little to no impact on high maternal mortality outcomes. As a result, there has been a shift toward skilled birth attendants, capable of averting and managing childbirth complications.Traditional birth attendants have performed wide variety of tasks including outreach and case finding, health and patient education, referrals, home visits and care management. The role of TBAs is vital to a rural woman and should not be under-looked: they are highly respected members and proven assets in addressing poor maternal outcomes. Problem statement:While there is some reason to celebrate the decrease in mortality rates , senior health officials caution against being complacent, as Uganda is still quite behind in achieving the Millennium Development Goals (MDGs) to reduce infant mortality and increase maternal health. To address these problems, the Ugandan Ministry of Health (MOH) identified several strategies and activities. Some of these activities included expanding the referral system using ICT. A number  of information communications technology (ICT) were and implemented for example Electronic Medical Records system (EMR) where selected but have not been efficient enough because of a number of factors, which include: unavailability of electric power supply in most rural areas, lack of smartphones to run the application, the need for the ICT to be accessed twenty four hours a day, flexibility, the need to access the system in other parts of the country and the economic sustainability of the system when donor pull out.With the affecting factors the development of an ICT maternal health support system  it will help TBAs to bridge the gap in the way they share and process information got from their communities all this accomplished using  mobile phones and telecom networks for data sharing. ICTs is enhanced if the technology is appropriate to the local conditions in the area (Dr. Maria G.N. Musoke (PhD) 2002) this will  to help the 43% of the women who are not able to deliver babies in health facilities this system maternal health will be reduced in rural area in Uganda.