‘Who assisted with the delivery of (NAME)?’ Issues in estimating skilled birth attendant coverage through population-based surveys and implications for improving global tracking

The percentage of live births attended by a skilled birth attendant (SBA) is a key global indicator and proxy for monitoring progress in maternal and newborn health. Yet, the discrepancy between rising SBA coverage and non-commensurate declines in maternal and neonatal mortality in many low-income a...

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Main Authors: Emma Radovich, Loveday Penn-Kekana, Kerry Wong, Oona Maeve Renee Campbell
Format: Article
Language:English
Published: BMJ Publishing Group 2019-03-01
Series:BMJ Global Health
Online Access:https://gh.bmj.com/content/4/2/e001367.full
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author Emma Radovich
Loveday Penn-Kekana
Kerry Wong
Oona Maeve Renee Campbell
author_facet Emma Radovich
Loveday Penn-Kekana
Kerry Wong
Oona Maeve Renee Campbell
author_sort Emma Radovich
collection DOAJ
description The percentage of live births attended by a skilled birth attendant (SBA) is a key global indicator and proxy for monitoring progress in maternal and newborn health. Yet, the discrepancy between rising SBA coverage and non-commensurate declines in maternal and neonatal mortality in many low-income and middle-income countries has brought increasing attention to the challenge of what the indicator of SBA coverage actually measures, and whether the indicator can be improved. In response to the 2018 revised definition of SBA and the push for improved measurement of progress in maternal and newborn health, this paper examines the evidence on what women can tell us about who assisted them during childbirth and methodological issues in estimating SBA coverage via population-based surveys. We present analyses based on Demographic and Health Surveys and Multiple Indicator Cluster Surveys conducted since 2015 for 23 countries. Our findings show SBA coverage can be reasonably estimated from population-based surveys in settings of high coverage, though women have difficulty reporting specific cadres. We propose improvements in how skilled cadres are classified and documented, how linkages can be made to facility-based data to examine the enabling environment and further ways data can be disaggregated to understand the complexity of delivery care. We also reflect on the limitations of what SBA coverage reveals about the quality and circumstances of childbirth care. While improvements to the indicator are possible, we call for the use of multiple indicators to inform local efforts to improve the health of women and newborns.
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spelling doaj-art-2d0e28d7eec44dc0b90e2bed5eb46bae2024-12-15T10:40:08ZengBMJ Publishing GroupBMJ Global Health2059-79082019-03-014210.1136/bmjgh-2018-001367‘Who assisted with the delivery of (NAME)?’ Issues in estimating skilled birth attendant coverage through population-based surveys and implications for improving global trackingEmma Radovich0Loveday Penn-Kekana1Kerry Wong2Oona Maeve Renee Campbell3Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UKInfectious Disease Epidemiology and International Health, London School of Hygiene and Tropical Medicine, London, UKFaculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UKInfectious Disease Epidemiology and International Health, London School of Hygiene and Tropical Medicine, London, UKThe percentage of live births attended by a skilled birth attendant (SBA) is a key global indicator and proxy for monitoring progress in maternal and newborn health. Yet, the discrepancy between rising SBA coverage and non-commensurate declines in maternal and neonatal mortality in many low-income and middle-income countries has brought increasing attention to the challenge of what the indicator of SBA coverage actually measures, and whether the indicator can be improved. In response to the 2018 revised definition of SBA and the push for improved measurement of progress in maternal and newborn health, this paper examines the evidence on what women can tell us about who assisted them during childbirth and methodological issues in estimating SBA coverage via population-based surveys. We present analyses based on Demographic and Health Surveys and Multiple Indicator Cluster Surveys conducted since 2015 for 23 countries. Our findings show SBA coverage can be reasonably estimated from population-based surveys in settings of high coverage, though women have difficulty reporting specific cadres. We propose improvements in how skilled cadres are classified and documented, how linkages can be made to facility-based data to examine the enabling environment and further ways data can be disaggregated to understand the complexity of delivery care. We also reflect on the limitations of what SBA coverage reveals about the quality and circumstances of childbirth care. While improvements to the indicator are possible, we call for the use of multiple indicators to inform local efforts to improve the health of women and newborns.https://gh.bmj.com/content/4/2/e001367.full
spellingShingle Emma Radovich
Loveday Penn-Kekana
Kerry Wong
Oona Maeve Renee Campbell
‘Who assisted with the delivery of (NAME)?’ Issues in estimating skilled birth attendant coverage through population-based surveys and implications for improving global tracking
BMJ Global Health
title ‘Who assisted with the delivery of (NAME)?’ Issues in estimating skilled birth attendant coverage through population-based surveys and implications for improving global tracking
title_full ‘Who assisted with the delivery of (NAME)?’ Issues in estimating skilled birth attendant coverage through population-based surveys and implications for improving global tracking
title_fullStr ‘Who assisted with the delivery of (NAME)?’ Issues in estimating skilled birth attendant coverage through population-based surveys and implications for improving global tracking
title_full_unstemmed ‘Who assisted with the delivery of (NAME)?’ Issues in estimating skilled birth attendant coverage through population-based surveys and implications for improving global tracking
title_short ‘Who assisted with the delivery of (NAME)?’ Issues in estimating skilled birth attendant coverage through population-based surveys and implications for improving global tracking
title_sort who assisted with the delivery of name issues in estimating skilled birth attendant coverage through population based surveys and implications for improving global tracking
url https://gh.bmj.com/content/4/2/e001367.full
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