One critical strategy for reducing maternal morbidity and mortality is ensuring that every baby is delivered with the assistance of a skilled birth attendant which generally includes a medical doctor, nurse or midwife. Experts agree that the risk of stillbirth or death due to intrapartum–related complication can be reduced by about 20 percent with the presence of a skilled birth attendant. Reflecting its importance in reducing maternal morbidity and mortality, skilled birth attendance was included as Indicator 3.1.2 under Goal 3 and Target 3.1 of the Sustainable Development Goals.
To improve maternal and newborn survival across all ages, skilled health personnel should be capable of handling normal deliveries safely. They must also be able to recognize warning signs for complications and refer mothers to emergency care. Non-skilled attendants, including traditional birth attendants, can neither predict nor appropriately manage serious complications such as haemorrhage or sepsis, which are the leading killers of mothers during and after childbirth.
Globally in 2016, about one in five births (21 per cent) take place without the assistance of a skilled birth attendant. In 2016, this translated into nearly 31 million unattended births worldwide. Coverage of skilled birth attendance across regions ranges from 99 per cent in Central and Eastern Europe and the Commonwealth of Independent States (CEE/CIS) to 51 per cent in West and Central Africa.
Maternal and Newborn Health Disparities Country Profiles
These statistical profiles present current levels of key impact, service delivery and coverage interventions for mothers and newborns with a wide array of disaggregation including residence, household wealth, mother’s age, mother’s education and sub-regional levels.
Every Newborn Action Plan: Country Implementation Tracking Tool Guidance Note
The purpose of the tool is to track ENAP implementation and progress made by countries towards achieving the national milestones (table 1). Special emphasis is put on tracking processes in place to ensure ENAP is implemented. The tool is a pathway to inform countries and partners on progress and to facilitate provision of country technical support needed to scale up MNH programme.
Indicator and Monitoring Framework for the Global Strategy for Women’s, Children’s and Adolescents’ Health
This report presents the indicator and monitoring framework for the Global Strategy for Women’s, Children’s and Adolescents’ Health, (2016-2030) focusing on its Survive, Thrive and Transform objectives and 17 targets. The report details the selection process for the indicators and implications for monitoring, measurement, investments and reporting.
The Global Strategy for Women’s, Children’s and Adolescents’ Health
The Global Strategy (2016-2030) is a roadmap to achieve right to the highest attainable standard of health for all women, children and adolescents –to transform the future and ensure every newborn, mother and child not only survives, but thrives. The new Strategy – updated through a process of collaboration with stakeholders led by WHO – builds on the success of the 2010 Strategy and its Every Woman Every Child movement as a platform to accelerate the health-related Millennium Development Goals and puts women, children and adolescents at the heart of the new UN Sustainable Development Goals.
Pregnancy, Childbirth, Postpartum and Newborn Care: A Guide for Essential Practice
This revised guide brings a full range of updated evidence – based norms and standards that enable health care providers at the first health care level to provide high-quality, integrated care during pregnancy and childbirth and after birth, both for mothers and babies. This guide will support countries in their efforts to reach every woman and child and ensure that pregnancy, birth and the first postnatal weeks are the joyful and safe experience they should be. The guide will be updated periodically as new WHO recommendations become available.
Trends in Maternal Mortality: 1990 to 2015
This summary presents new estimates of maternal mortality produced by the Maternal Mortality Estimation Inter-Agency Group (MMEIG) as part of global and country monitoring of the Millennium Development Goal five. The estimates for 1990 to 2015 presented in this summary are the eighth in a series of analyses by the MMEIG to examine global, regional and country progress in reducing maternal mortality.
Strategies toward ending preventable maternal mortality
The Ending Preventable Maternal Mortality (EPMM) targets and strategies are grounded in a human rights approach to maternal and newborn health, and focus on eliminating significant inequities that lead to disparities in access, quality and outcomes of care within and between countries. Concrete political commitments and financial investments by country governments and development partners are necessary to meet the targets and carry out the strategies for EPMM.
Committing to Child Survival: A Promise Renewed – Progress Report 2014
This report looks at causes of death and coverage of key interventions for mother and newborn and highlights initiatives by governments, civil society and the private sector to accelerate progress on child survival.
UNICEF – in collaboration with WHO – is the UN organization responsible for monitoring and reporting “Proportion of births attended by skilled health personnel”, an official indicator for Goal 3 of the Sustainable Development Goals.
| SDG indicator | Sustainable Development Goal | Target |
| 3.1.2: Proportion of births attended by skilled health personnel (doctors, nurses, midwives) |
Goal 3: Ensure healthy lives and promote well-being for all at all ages |
Target 3.1: By 2030, reduce the global maternal mortality ratio to less than 70 per 100,000 live births |
DEFINITION
Definition:
The proportion of births attended by skilled health personnel as defined as the percentage of live births attended by skilled health personnel (doctors, nurses, midwives) during a specified time period, generally up to the past five years.
Computation:
The indicator is computed as the number of live births attended by skilled health personnel (generally doctors, nurses or midwives) out of total number of live births in a specified reference period.
Limitations:
Standardization of the definition of skilled health personnel can be challenging on account of differences in training of health personnel across countries. Although efforts have been made to standardize the definitions of doctors, nurses, midwives (and in some cases, auxiliary midwives) used in most household surveys, it is likely that the abilities of many skilled attendants to provide appropriate care in an emergency depends on the environment in which they work. Additionally, this indicator is a measure of a health system’s ability to provide adequate care for pregnant women; however, concerns have been expressed that the presence of a skilled attendant may not adequately capture women’s access to good-quality care, particularly when complications arise, and that information on the supplies and equipment a skilled attendant may or may not have is lacking.
Database:
Since 2015, UNICEF and WHO have maintained a joint database on skilled attendant at birth. Joint estimates are published annually, released simultaneously in May by UNICEF and WHO in the State of the World’s Children report, and are available at www.data.unicef.org and World Health Statistics (http://www.who.int/whosis/whostat/en/), respectively. As skilled attendance at delivery is an SDG indicator (3.1.2), databases and regional estimates are also provided for SDG data releases on an annual basis.