The maternal mortality ratio and the proportion
of births attended by skilled health personnel
are the two indicators used to monitor
progress towards achievement of the 5th
Millennium Development Goal (MDG) which
aims to improve maternal health.
Measuring maternal mortality accurately is
difficult, except where there is comprehensive
registration of deaths and causes of death
(Stanton et al. 1997, Stanton et al. 2000).
In addition, although unacceptably high in
developing countries, a maternal death is still
a relatively rare event to capture changes
during short intervals.
Among the potential process indicators to
track changes in maternal mortality levels,
“proportion of births attended by skilled health
personnel” is being accepted to be the most
relevant due to the historical data showing
a correlation between having skilled care
at delivery and declining maternal mortality
(Graham et al. 2001). It is, therefore, a key
indicator for the MDG 5 of improving maternal
health and its target of reducing maternal
mortality.