SKILLED ATTENDANT AT BIRTH MDG 5, TARGET 5A, INDICATOR 5.2 Workshop on MDG monitoring to 2015 and...
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Transcript of SKILLED ATTENDANT AT BIRTH MDG 5, TARGET 5A, INDICATOR 5.2 Workshop on MDG monitoring to 2015 and...
SKILLED ATTENDANT AT BIRTH
MDG 5, TARGET 5A, INDICATOR 5.2
Workshop on MDG monitoring to 2015 and beyond
Bangkok 9-13 July 2012Liliana CarvajalUNICEF
MDG 5 – Improve maternal health
Target 5.a – Reduce by three quarters, between 1990 and 2015, the maternal mortality ratio
Indicator 5.2– Proportion of births attended by skilled health personnel
Background, definitions and relevance National and regional perspective Measuring the standard indicator Summary of methodological challenges
Skilled attendant at birth
Background, definitions and relevance National and regional perspective Measuring the standard indicator Summary of methodological challenges
Skilled attendant at birth
Background
Every year…. 287,000 maternal deaths For each maternal death 20 women suffer
injuries or disabilities related to pregnancy/childbirth
Approximately 3 million neonatal deaths
Greatest mortality risk for both mothers and children is during
delivery and immediately after birth
Who is a skilled attendant?
A skilled attendant is an accredited health professional – such as a midwife, doctor or nurse – who has been educated and trained to proficiency in the skills needed to manage normal (uncomplicated) pregnancies, childbirth, and the immediate postnatal period, and in the identification, management and referral of complications in women and newborns.
Traditional birth attendants, who are not formally trained, do not meet the definition of skilled birth attendants.
Source: 2004 Joint statement by WHO, ICM and FIGO, endorsed by UNFPA and the Word Bank
Why does it matter?
The presence of a trained health-care worker during delivery is crucial in reducing maternal deaths.
The single most critical intervention for safe motherhood is to ensure a skilled birth attendant is present at every birth, and transport is available to a referral facility for obstetric care in case of emergency.
A skilled health professional can administer interventions to prevent and manage life-threatening complications, such as heavy bleeding, or refer the patient to a higher level of care when needed.
Background, definitions and relevance National and regional perspective Measuring the standard indicator Summary of methodological challenges
Skilled attendant at birth
Asian countries – coverage of skilled attendance at delivery
* Latest data value is for 2005, 2006
around
Skilled attendant at birthProportion of births attended by skilled health personnel,around 1990 and around 2009 (Percentage)
Developing regions – moderate progress from 55 per cent in 1990 to 65 per cent in 2009.
Sub-Saharan Africa and Southern Asia: substantial progress but more needs to be done as the majority of maternal deaths occur in these regions.
Source: MDG report 2011
Background, definitions and relevance National and regional perspective Measuring the standard indicator Summary of methodological challenges
Skilled attendant at birth
Standard Indicator
Skilled attendant at deliveryProportion of women age 15-49 years with a live birth in the 2 years preceding the survey who were attended during childbirth by skilled health personnel
Note:Skilled provider means: DoctorNurse Midwife (and auxiliary midwife when appropriate)
Sources
The proportion of births attended by skilled health personnel is typically calculated from data collected through national household surveys including: Multiple Indicator Cluster Surveys (MICS) Demographic Health Surveys (DHS), Reproductive Health Surveys and sometimes from data collected from
administrative registrations.
Eligibility
Women of reproductive age (15-49 years)
Live birth in the two or five years preceding interview
Household survey – women’s questionnaire
Who assisted with the delivery of your last baby?
Skilled birth attendants
Household survey – women’s questionnaire
Multiple categories of skilled personnel
Questionnaires need to be adapted carefully at the country level
Do these additional categories meet the standard to be considered skilled?
Reporting of skilled attendants Bangladesh example: Medically trained providers include -
Qualified doctor, Nurse/midwife/paramedic, Family welfare assistant FWV, Community skilled birth attendant CSBA
Are all these categories skilled? For global reporting, confirmation from countries is needed for extra categories
Reporting of skilled attendants Bhutan example: Skilled providers include - doctor,
nurse/midwife, health assistant/basic health worker HA/BW or assistant clinical officer ACO.
Are all these categories skilled? For global reporting, confirmation from countries is needed for extra categories
Background, definitions and relevance National and regional perspective Measuring the standard indicator Summary of methodological challenges
Skilled attendant at birth
Summary of methodological challenges Type of health provider - birth attendant is
skilled or not? Questionnaires - coding categories need to be
adapted in country MDG indicators – maintain broad coding categories
for comparability Direct communication with country office to
ensure correct interpretation for global reporting
www.childinfo.org
Prepared by: Liliana Carvajal / Statistics and Monitoring Section, UNICEF/New [email protected]
Thank you!