Skilled birth attendant competence: an initial assessment in four countries, and implications for the Safe Motherhood movement

Percentage of deliveries assisted by a skilled birth attendant (SBA) has become a proxy indicator for reducing maternal mortality in developing countries, but there is little data on SBA competence. Our objective was to evaluate the competence of health professionals who typically attend hospital an...

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Bibliographic Details
Published in:International journal of gynecology and obstetrics 2004-11, Vol.87 (2), p.203-210
Main Authors: Harvey, S.A., Ayabaca, P., Bucagu, M., Djibrina, S., Edson, W.N., Gbangbade, S., McCaw-Binns, A., Burkhalter, B.R.
Format: Article
Language:English
Subjects:
Benin - epidemiology
Biological and medical sciences
Clinical Competence
Clinical competence/standards
Delivery. Postpartum. Lactation
Ecuador - epidemiology
Female
Gynecology. Andrology. Obstetrics
Humans
Infant, Newborn
Jamaica - epidemiology
Maternal Health Services - standards
Maternal mortality
Medical sciences
Midwifery - standards
Midwifery - statistics & numerical data
Outcome Assessment (Health Care)
Practice Guidelines as Topic
Pregnancy
Pregnancy Complications - mortality
Pregnancy Complications - prevention & control
Pregnancy complications/mortality/prevention and control
Rwanda - epidemiology
Skilled attendance at delivery
Skilled birth attendant
World Health Organization
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Summary:Percentage of deliveries assisted by a skilled birth attendant (SBA) has become a proxy indicator for reducing maternal mortality in developing countries, but there is little data on SBA competence. Our objective was to evaluate the competence of health professionals who typically attend hospital and clinic-based births in Benin, Ecuador, Jamaica, and Rwanda. Methods: We measured competence against World Health Organization's (WHO) Integrated Management of Pregnancy and Childbirth guidelines. To evaluate knowledge, we used a 49-question multiple-choice test covering seven clinical areas. To evaluate skill, we had participants perform five different procedures on anatomical models. The 166 participants came from facilities at all levels of care in their respective countries. Results: On average, providers answered 55.8% of the knowledge questions correctly and performed 48.2% of the skills steps correctly. Scores differed somewhat by country, provider type, and subtopic. Conclusion: A wide gap exists between current evidence-based standards and current levels of provider competence.
ISSN:0020-7292
1879-3479
DOI:10.1016/j.ijgo.2004.06.017