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

Type Journal Article - International Journal of Gynecology & Obstetrics
Title Skilled birth attendant competence: an initial assessment in four countries, and implications for the Safe Motherhood movement
Author(s)
Volume 87
Issue 2
Publication (Day/Month/Year) 2004
Page numbers 203-210
URL http://www.unfpa.org/sowmy/resources/docs/library/R029_Harvey_etal_2004_SBA_CompetencyArticle_IJGO_2​004.pdf
Abstract
Objectives: 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

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