Despite accelerated recent progress, millions of births occur annually without any assistance from a skilled attendant at birth
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.
Despite substantial progress over the last two decades, inadequate or non-existent care during pregnancy and delivery was largely responsible for the annual deaths of an estimated 303,000 mothers and 2.5 million newborns in the first month of life in 2017. Indeed, roughly three-quarters of all maternal deaths take place during delivery and in the immediate postpartum period.
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Notes on the data
UNICEF – in collaboration with WHO – is the custodian agency responsible for monitoring and reporting “Proportion of births attended by skilled health personnel”, an official indicator for Goal 3 of the Sustainable Development Goals.
| Sustainable Development Goal | Target | Indicator |
| 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 |
3.1.2: Proportion of births attended by skilled health personnel (doctor, nurse, midwife) |
Definition:
The proportion of births attended by skilled health personnel as defined as the percentage of live births attended by skilled health personnel (doctor, nurse, midwife).
Computation:
The indicator is computed as the number of live births attended by skilled health personnel 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.