Skilled Attendant at Delivery

MICS3 Data Analysis and Report Writing

Background

• Three-quarters of all maternal deaths occur during delivery and the immediate postpartum period.

• Traditional birth attendants, whether trained or untrained, can neither predict nor cope with serious obstetric complications.

• The single most critical intervention for safe motherhood is thus to ensure that a competent health worker with midwifery skills is present at every birth, and transport is available to a referral facility for obstetric care in case of emergency.

International Goals & Targets

Ensure that women have ready and

affordable access to skilled attendance

at delivery

Proportion of births attended by skilled health personnel

(MDG 5, Indicator 17)

List of Indicators

• Skilled attendant at delivery

• Institutional deliveries

Definition of Indicator

Skilled Attendant at Delivery% births attended by skilled

health personnel (doctors, nurses, midwives or auxiliary midwives)

Numerator: Number of women aged 15-49 years with a birth in the 2 years prior to the survey who were attended during childbirth by skilled health personnel

Denominator: Total number of women surveyed aged 15-49 years with a birth in the 2 years prior to the survey

Definition of Indicator

Institutional Deliveries% women aged 15-49 years that gave birth in a health facility in the previous 2 years

Numerator: Number of women aged 15-49 years with a birth in the 2 years prior to the survey that delivered in a health facility

Denominator: Total number of women surveyed aged 15-49 years with a birth in the 2 years prior to the survey

Methodological Issues

• Skilled attendant at delivery is used as a proxy to assess trends in maternal mortality

• Skilled attendants include doctors, nurses, midwives or auxiliary midwives (not included are traditional birth attendants)

• Health facilities include the following:- government hospital - government clinic/health center - other government facility- private hospital - private clinic - private maternity home- other private medical facility

Tabulation PlanTable RH.5: Assistance during delivery

Regional SKAT Coverage

Skilled Attendant at Delivery

9387 86

76

4539 36

59

0

20

40

60

80

100

Trend Data

Trends in Skilled Attendant at Delivery

3035

47

72

48

93

4436

41 46

88 8894

59

0

20

40

60

80

100

South A

sia

West

ern/C

entral A

frica

Easte

rn/S

outher

n Afri

ca

Latin

Am

eric

a/Car

ibbea

n

East A

sia/P

acifi

c

CEE/CIS

Develo

ping c

ountries

% b

irth

s a

tte

nd

ed

by

sk

ille

d h

ea

lth

pe

rso

nn

el

1990

2002

93

718384

93969697979898999999999999100100100100

0 20 40 60 80 100

CEE/CIS

Tajikistan

Turkey

Azerbaijan

Serbia/Montenegro

Georgia

Uzbekistan

Armenia

Turkmenistan

Albania

Kyrgyzstan

Bulgaria

Kazakhstan

Moldova, Rep. of

Romania

Russian Federation

Macedonia, TFYR

Belarus

Bosnia/Herzegovina

Croatia

Ukraine

SKAT Coverage (CEE/CIS)

% births

attended

by

skilled health

personnel

87

2441

5659

6767

6977

83858686

92939495969697989899999999100100100100100100100100

0 20 40 60 80 100

Latin America/Caribbean

Haiti

Guatemala

Honduras

Peru

Bolivia

Nicaragua

Ecuador

Paraguay

Belize

Suriname

Colombia

Guyana

El Salvador

Panama

Venezuela

Mexico

Brazil

Trinidad/Tobago

Jamaica

Barbados

Costa Rica

Argentina

Bahamas

DR

Saint Kitts/Nevis

Antigua/Barbuda

Chile

Cuba

Dominica

Grenada

Saint Lucia

Saint Vincent/Grenadines

Uruguay

SKAT Coverage (TACRO)% birthsattended

by skilled health

personnel

SKAT Coverage (MENA)

% births

attended

by

skilled health

personnel

76

2761

6369

72

778789

909091

94

959697

989899

99100

0 20 40 60 80 100

Middle East/North Africa

Yemen

Djibouti

Morocco

Egypt

Iraq

Syria

Sudan

Lebanon

Iran

Tunisia

Saudi Arabia

Libya

Oman

Algeria

OPT

Bahrain

Kuwait

Qatar

UAE

Jordan

% births attended by skilled health personnel

86

1819

3241

5760

72858585

8888

95959697979798999999100100100100100100

0 20 40 60 80 100

East Asia/Pacific

Timor-Leste

Lao PDR

Cambodia

PNG

Myanmar

Philippines

Indonesia

Kiribati

Solomon Islands

Viet Nam

Micronesia

Vanuatu

Marshall Islands

Tonga

China

Korea, Dem Rep

Malaysia

Mongolia

Cook Islands

Brunei Darussalam

Fiji

Thailand

Korea, Rep of

Niue

Palau

Samoa

Singapore

Tuvalu

SKAT Coverage (EAPRO)

% births

attended

by

skilled health

personnel

SKAT Coverage (ESARO)

% births

attended

by

skilled health

personnel

39

6

25

25

28

31

39

42

43

45

46

48

51

60

61

62

73

74

76

84

94

98

0 20 40 60 80 100

East/Southern Africa

Ethiopia

Burundi

Somalia

Eritrea

Rwanda

Uganda

Kenya

Zambia

Angola

Tanzania

Mozambique

Madagascar

Lesotho

Malawi

Comoros

Zimbabwe

Swaziland

Namibia

South Africa

Botswana

Mauritius

45

0

16

35

35

38

41

42

44

47

51

55

56

57

58

61

61

62

65

66

68

76

8689

0 20 40 60 80 100

West/Central Africa

Congo

Chad

Niger

Guinea-Bissau

Nigeria

Burkina Faso

Mali

Sierra Leone

CAR

Ghana

Liberia

Gambia

Guinea

Mauritania

Senegal

Congo, Dem Rep

Togo

Cameroon

Eq. Guinea

Benin

Côte d'Ivoire

Sao Tome/Principe

Gabon

Cape Verde

SKAT Coverage (WCARO)

% births

attended

by

skilled health

personnel

36

13

14

15

23

37

43

70

96

0 20 40 60 80 100

South Asia

Bangladesh

Afghanistan

Nepal

Pakistan

Bhutan

India

Maldives

Sri Lanka

SKAT Coverage (ROSA)

% births

attended

by

skilled health

personnel