Skilled birth attendance in Sierra Leone, Niger, and Mali: analysis of demographic and health surveys

Abstract

Background: Skilled birth attendance (SBA) is a key strategy for averting maternal mortality ratio (MMR). The lifetime risk of maternal death is high in countries with low SBA. With the presence of a skilled birth attendant, the possibility of death owing to intrapartum-related complications or stillbirth can be reduced by 20%. Methods: Using data from the most recent Demographic and Health Surveys, we investigated the prevalence of skilled birth attendance, variations, and associated factors. The sample was drawn from women aged 15-49 who were surveyed in these countries as part of the Demographic and Health Survey (DHS) program. With multivariate logistic regression, we explored the socio-demographic factors that predict women's likelihood of seeking skilled birth attendance or otherwise. Results: Less than half of the women in Niger, Sierra Leone, and Mali obtained skilled birth attendance, with the worst case occurring in Niger (32.6%). Women in rural areas have less likelihood of obtaining skilled birth attendance (OR 0.21; 95% CI 0.16-0.28), as compared to women in urban locations. Highly educated women (OR 2.50; 95% CI 0.72-8.69), those who had subscribed to health insurance (OR 1.39; 95% CI 0.88-2.20), those who obtain four or more antenatal care visits (OR 1.63; 95% CI 1.43-1.86), and women who watch television at least once a week (OR 2.33; 95% CI 1.88-2.88) are more probable to seek SBA. Conclusion: Interventions to increase SBA rates in these countries need to be reassessed to focus on the ruralurban disparity in healthcare, female education, and ANC attendance.

Determinants of preference for home childbirth over health facility childbirth among Women of Reproductive Age in Tanzania: An Analysis of Data from the 2015-16 Tanzania HIV and Malaria Indicators Survey

“…Although the analysis did not show a significant increase in preference to home childbirth in the rural community over the urban community, still innovative strategies to increase rural community awareness on risks associated with home childbirth is highly recommended. A similar study done in Sierra Leone, Niger and Mali reported a significant relationship between rural residence and preference for home childbirth [16] The study also found that pregnant women who had higher parity were more likely to prefer home childbirth over health facility birth. Pregnant women who had two to four children were 1.5 and those who had five and above were 2.2 more likely to have home childbirth if compared to those who were pregnant for their first time.…”

Exploring spatial variations and factors associated with skilled birth attendant delivery in Ethiopia: geographically weighted regression and multilevel analysis

“…Eighty percent of live births in the world and 59% of births in sub-Saharan Africa are attended by skilled health personnel [16]. This prevalence of SBA delivery in sub-Saharan Africa also varies across countries ranging from 13% in Nigeria to 77% in Kenya [17][18][19][20]. In Ethiopia, only 18.8 to 29.2% of births are attended by skilled health personnel [2,21,22].…”

Assisted Birth Delivery In Ghana: Evidence From Ghana Demographic And Health Survey 1988 - 2014

“…Strategies to improve maternal health are constrained by inadequate skilled birth attendants and underfunding of maternal and child health [12]. Other factors obstructing progress toward improving maternal health include barriers to accessing healthcare, inadequate essential supplies, lack of emergency transport systems and poor referral services [13].…”

“…An insigni cant number of the deaths (1%) occur in the developed countries as a result of availability and accessibility of quality of care by pregnant women in the developed countries. This quality care includes skilled attendant at the delivery point [12].…”

“…The government of Ghana introduced a maternal care exemption fee policy in 2007 to eliminate the nancial burden of access to maternal health services [15], enhance easy access to facilities, train more midwives, upgrade health assistant schools into midwifery schools, offer Community-based Health Planning and Services (CHPS) Program and train Community Health O cers (CHOs) as midwives to address the gap in skilled attendance [16,17,18,13,12].…”