Skilled Birth Attendants: who is who? A descriptive study of definitions and roles from nine Sub Saharan African countries - PubMed (original) (raw)

Skilled Birth Attendants: who is who? A descriptive study of definitions and roles from nine Sub Saharan African countries

Adetoro Adegoke et al. PLoS One. 2012.

Abstract

Background: Availability of a Skilled Birth Attendant (SBA) during childbirth is a key indicator for MDG5 and a strategy for reducing maternal and neonatal mortality in Africa. There is limited information on how SBAs and their functions are defined. The aim of this study was to map the cadres of health providers considered SBAs in Sub Saharan Africa (SSA); to describe which signal functions of Essential Obstetric Care (EmOC) they perform and assess whether they are legislated to perform these functions.

Methods and findings: Key personnel in the Ministries of Health, teaching institutions, referral, regional and district hospitals completed structured questionnaires in nine SSA countries in 2009-2011. A total of 21 different cadres of health care providers (HCP) were reported to be SBA. Type and number of EmOC signal functions reported to be provided, varied substantially between cadres and countries. Parenteral antibiotics, uterotonic drugs and anticonvulsants were provided by most SBAs. Removal of retained products of conception and assisted vaginal delivery were the least provided signal functions. Except for the cadres of obstetricians, medical doctors and registered nurse-midwives, there was lack of clarity regarding signal functions reported to be performed and whether they were legislated to perform these. This was particularly for manual removal of placenta, removal of retained products and assisted vaginal delivery. In some countries, cadres not considered SBA performed deliveries and provided EmOC signal functions. In other settings, cadres reported to be SBA were able to but not legislated to perform key EmOC signal functions.

Conclusions: Comparison of cadres of HCPs reported to be SBA across countries is difficult because of lack of standardization in names, training, and functions performed. There is a need for countries to develop clear guidelines defining who is a SBA and which EmOC signal functions each cadre of HCP is expected to provide.

PubMed Disclaimer

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1

Figure 1. Percentage of different types of cadres of Nurses/Midwives who perform each of the eight signal function by country.

Similar articles

Cited by

References

    1. WHO UNICEF. Countdown to 2015 decade report (2000–2010) with country profiles taking stock of maternal, newborn and child survival. Geneva; New York: World Health Organization; UNICEF. 2010.
    1. WHO UNICEF, The World Bank. Trends in maternal mortality 1990 to 2008: estimates. Geneva: World Health Organization. 2010.
    1. Lawn JE, Blencowe H, Pattinson R, Cousens S, Kumar R, et al. Stillbirths: Where? When? Why? How to make the data count? Lancet. 2011;377:1448–1463. - PubMed
    1. Oestergaard MZ, Inoue M, Yoshida S, Mahanani WR, Gore FM, et al. Neonatal mortality levels for 193 countries in 2009 with trends since 1990: a systematic analysis of progress, projections, and priorities. PLoS Medicine 8. 2011. - PMC - PubMed
    1. Scott S, Ronsmans C. The relationship between birth with a health professional and maternal mortality in observational studies: a review of the literature. Tropical Medicine & International Health. 2009;14:1523–1533. - PubMed

Publication types

MeSH terms

LinkOut - more resources