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Skilled birth attendant competence: an initial assessment in four countries, and implications for the Safe Motherhood movement
Author(s) -
Harvey S.A.,
Ayabaca P.,
Bucagu M.,
Djibrina S.,
Edson W.N.,
Gbangbade S.,
McCawBinns A.,
Burkhalter B.R.
Publication year - 2004
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1016/j.ijgo.2004.06.017
Subject(s) - medicine , childbirth , competence (human resources) , developing country , nursing , health care , fetal movement , family medicine , pregnancy , economic growth , social psychology , psychology , genetics , economics , biology , gestation
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.