Skilled Birth Attendants: who is who? A descriptive study of definitions and roles from nine Sub Saharan African countries.

Adegoke, Adetoro, Utz, Bettina, Msuya, Sia E. and Van Den Broek, Nynke ORCID: https://orcid.org/0000-0001-8523-2684 (2012) 'Skilled Birth Attendants: who is who? A descriptive study of definitions and roles from nine Sub Saharan African countries.'. PLoS ONE, Vol 7, Issue 7, e40220.

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Abstract

Background
Availability of a Skilled Birth Attendant (SBA) during childbirth is a key indicator for MDG5 and a strategy for reducing maternal and neonatal mortality in Africa. There is limited information on how SBAs and their functions are defined. The aim of this study was to map the cadres of health providers considered SBAs in Sub Saharan Africa (SSA); to describe which signal functions of Essential Obstetric Care (EmOC) they perform and assess whether they are legislated to perform these functions.

Methods and Findings
Key personnel in the Ministries of Health, teaching institutions, referral, regional and district hospitals completed structured questionnaires in nine SSA countries in 2009–2011. A total of 21 different cadres of health care providers (HCP) were reported to be SBA. Type and number of EmOC signal functions reported to be provided, varied substantially between cadres and countries. Parenteral antibiotics, uterotonic drugs and anticonvulsants were provided by most SBAs. Removal of retained products of conception and assisted vaginal delivery were the least provided signal functions. Except for the cadres of obstetricians, medical doctors and registered nurse-midwives, there was lack of clarity regarding signal functions reported to be performed and whether they were legislated to perform these. This was particularly for manual removal of placenta, removal of retained products and assisted vaginal delivery. In some countries, cadres not considered SBA performed deliveries and provided EmOC signal functions. In other settings, cadres reported to be SBA were able to but not legislated to perform key EmOC signal functions.

Conclusions
Comparison of cadres of HCPs reported to be SBA across countries is difficult because of lack of standardization in names, training, and functions performed. There is a need for countries to develop clear guidelines defining who is a SBA and which EmOC signal functions each cadre of HCP is expected to provide.

Item Type:	Article
Subjects:	WA Public Health > Health Problems of Special Population Groups > WA 310 Maternal welfare WQ Obstetrics > Childbirth. Prenatal Care > WQ 160 Midwifery WQ Obstetrics > Labor > WQ 330 Complications of labor WY Nursing > WY 157 Obstetrical nursing. Nurse midwifery
Faculty: Department:	Groups (2002 - 2012) > Child & Reproductive Health Group
Digital Object Identifer (DOI):	https://doi.org/10.1371/journal.pone.0040220
Depositing User:	Caroline Hercod
Date Deposited:	12 Oct 2012 10:50
Last Modified:	07 Jun 2022 11:09
URI:	https://archive.lstmed.ac.uk/id/eprint/3058

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