Where There Are (Few) Skilled Birth Attendants

Abstract

Recent efforts to reduce maternal mortality in developing countries have focused primarily on two long-term aims: training and deploying skilled birth attendants and upgrading emergency obstetric care facilities. Given the future population-level benefits, strengthening of health systems makes excellent strategic sense but it does not address the immediate safe-delivery needs of the estimated 45 million women who are likely to deliver at home, without a skilled birth attendant. There are currently 28 countries from four major regions in which fewer than half of all births are attended by skilled birth attendants. Sixty-nine percent of maternal deaths in these four regions can be attributed to these 28 countries, despite the fact that these countries only constitute 34% of the total population in these regions. Trends documenting the change in the proportion of births accompanied by a skilled attendant in these 28 countries over the last 15-20 years offer no indication that adequate change is imminent. To rapidly reduce maternal mortality in regions where births in the home without skilled birth attendants are common, governments and community-based organizations could implement a cost-effective, complementary strategy involving health workers who are likely to be present when births in the home take place. Training community-based birth attendants in primary and secondary prevention technologies (e.g. misoprostol, family planning, measurement of blood loss, and postpartum care) will increase the chance that women in the lowest economic quintiles will also benefit from global safe motherhood efforts.

Assessing the Magnitude of Institutional Delivery Service Utilization and Associated Factors among Mothers in Debre Berhan, Ethiopia

“…This result almost similar with the Addis Ababa city health facility delivery utilization coverage which is 82.2% studied in the Ethiopian Health and demography survey before 2 years in 2011 [1]. In Ethiopia most of the studies before twothree years especially in the rural setting in the extent of Institutional delivery service utilization was extremely low which is 10% from DHS-2011 [3][4][5][6] 12.1% a study conducted in Sekela Woreda in West Gojam [7][8][9][10][11][12], Even this study shows increment than a study conducted in a town setup which is 48.3% in Woldiya town [11], 50% in the Urban areas of Ethiopia including Addis Ababa DHS 2011 shows [1] this finding might be, different in number of sample size, methodology difference, socio-demographic characteristics like urban to rural proportion and cultural difference in the study area and another discrepancy from the other studies may be because of the current Government initiative to reduce maternal mortality to achieve MDG5 because of reaching the end year and the other reason may be accessibility of health institution and Ambulance service at grass root level [2, 4,7].…”

Factors Affecting Prenatal Care Utilization in East Wollega Zone, Oromia Regional State, Ethiopia

“…However, trends documenting the change in the proportion of births accompanied by prenatal care and skilled attendant over the last 15-20 years offer no indication that adequate change is imminent. To improve maternal health rapidly in regions where births in the home without skilled birth attendants are common, governments and communitybased organizations could implement a cost-effective strategy (Prata et al 2011;Adegoke et al, 2012).…”

“…However, the proportion of births with a skilled attendant is 8.1% in Oromia regional state. Therefore identifying the factors affecting prenatal care and skilled attendance for delivery is a priority area for interventions (EDHS, 2011;Sohail and Thomas, 2011;Ronsmans, et al, 2003;Prata et al, 2011).…”

Mensuração de desigualdades sociais em saúde: conceitos e abordagens metodológicas no contexto brasileiro*

“…1,2 However, such estimates often hide significant differences among population subgroups. [2][3][4] In addition, promoting equality among these subgroups and prioritizing the improvement of indicators among vulnerable groups may be an efficient strategy to improve the national indicators.…”

“…1,2 However, such estimates often hide significant differences among population subgroups. [2][3][4] In addition, promoting equality among these subgroups and prioritizing the improvement of indicators among vulnerable groups may be an efficient strategy to improve the national indicators. [4][5][6][7] The Sustainable Development Goals (SDG) proposed by the United Nations in 2015, on the basis of the Millennium Development Goals (MDG), emphasize the importance of universal health care and the need to tackle inequality.…”