Are skilled birth attendants really skilled? A measurement method, some disturbing results and a potential way forward

Skilled birth attendance is an indicator in measuring reductions in maternal mortality, but this article in the Bulletin of the World Health Organization casts doubt on the assumption that “skilled” (e.g., graduated from certified or accredited programs) attendants actually are. This large-scale, five-country study contributes to ongoing efforts to improve birth attendance competency. Results showed significant variations in competency between different evaluation components and different cadres, with “troubling” and “generally low scores.” Many participants scored poorly on basic questions related to infection prevention (e.g., hand-washing), and the active management of the third stage of labor was largely unknown in many countries. These systemic problems require comprehensive quality improvement initiatives, and much effort must be directed at raising basic competencies.

Harvey SA, YC Blandon, A McCaw-Binns, I Sandino, L Urbina, C Rodriguez, I Gomez, P Ayabaca, P, S Djibrina,  Nicaragua maternal and neonatal health care improvement group, “Are skilled birth attendants really skilled? A measurement method, some disturbing results and a potential way forward,” Bulletin of the World Health Organization 85 (2007): 783–790.

Publication Date 
October 2007
Authors 
Harvey SA, YC Blandon, A McCaw-Binns, I Sandino, L Urbina, C Rodriguez, I Gomez, P Ayabaca, P, S Djibrina
Resource Type 
Publications
Peer-reviewed Journal Articles