Delivery care

Adolescent mothers

Currently, the highest rates of early childbearing are found in sub-Saharan African countries, where in 2018 birth rates among adolescents reached over 100 births per 1000 girls aged 15-19, compared to lower rates in other regions. It is important that girls in this vulnerable group receive the necessary care during antenatal period and delivery to ensure their wellbeing and that of their babies as well as education on family planning. See more

Disparities in coverage

Despite progress made, large equity gaps remain, with the rural or the poorest population often left behind. Globally, approximately 67 percent of births among rural mothers are attended by skilled health personnel, compared to about 89 percent of births among urban mothers. The urban-rural gap remains at over 20 percentage points despite progress in the past 15 years.

Large disparities in delivery care are also observed across wealth quintiles. Globally, women in the richest 20 per cent of their countries’ population were almost 2 times more likely than women in the poorest quintile to have a skilled birth attendant at delivery (91 per cent versus 51 per cent). Differences across wealth quintiles are largest in sub-Saharan Africa with the richest being 2.4 times more likely to deliver with the help of a skilled health provider than the poorest (37% versus 88%). This is especially true in West and Central Africa where the richest 20 per cent of mothers were almost 3 times as likely to have a skilled birth attendance at delivery than mothers in the poorest 20% of the households (32% versus 88%).

Delivery in health facilities

Monitoring deliveries in health facilities is essential to ensuring that women receive quality care and deliver in an environment that is prepared for an emergency. In many countries, particularly middle- and high-income countries, a large proportion of babies are delivered in health facilities. Delivery in a health facility increases access to appropriate equipment and supplies available on site or through immediate referral to a higher level facility. However it remains essential to also ensure that the delivery is carried out by skilled health personnel, capable of anticipating or detecting signs and symptoms of complications. In Eastern Europe and Central Asia (97 percent), Western Europe (99 percent), Latin America and the Caribbean (94 per cent) as well as East Asia and the Pacific (90 percent), over 9 in 10 births occurred in health facilities. In contrast, in sub-Saharan Africa where the burden of maternal and newborn deaths is highest, just over half of all births (57 percent) were delivered in a health facility and the urban-rural gap was 30 percentage points (78% vs. 48%) and the gap between women from the richest and poorest quintiles of their national populations was a staggering 49 percentage points (85 per cent vs. 36 per cent).

The percent of births taking place in a health facility varies by UNICEF region

References

UNICEF, The State of the World’s Children 2016, UNICEF, New York, 2016.

UNICEF, Committing to Child Survival: A Promise Renewed – 2015, UNICEF, New York, 2015.

UNICEF, The State of the World’s Children 2011: Adolescence – An age of opportunity, UNICEF, New York, 2011.

WHO, UNFPA, UNICEF, AMDD, Monitoring Emergency Obstetric Care – A handbook, 2009 revision, WHO, Geneva 2009.

WHO, UNICEF, UNFPA and The World Bank, Trends in Maternal Mortality: 1990 to 2015, WHO, Geneva, 2012.