Impact of Training on Traditional Birth Attendants on Maternal Mortality in South Sudan: A Three-Year Follow-Up Study

Traditional birth attendants (TBAs) play a crucial role in maternal health services in South Sudan, particularly among rural and marginalized populations. A mixed-methods approach was employed, including baseline surveys, follow-up assessments, and qualitative interviews to analyse changes in TBA practices and outcomes. TBAs who received training showed significant improvements in recognising life-threatening conditions (90% reported an increase), leading to a reduction in maternal mortality by 25% over the three-year period. However, challenges persist with only 60% of trained TBAs practicing recommended protocols consistently. Training interventions appear effective in improving TBA practices but require continued support and reinforcement for sustained impact on maternal outcomes. Continuous education programmes should be implemented to ensure consistent application of training by TBAs, coupled with supportive policies that enhance their role in maternal health services. Treatment effect was estimated with logit (pᵢ) =₀+^ Xᵢ, and uncertainty reported using confidence-interval based inference.