Can Skilled Birth Attendants Reduce Neonatal Mortality?
A Regional Multilevel Analysis: Can Skilled Birth Attendants Uniformly Decrease Neonatal Mortality?
Globally 40% of deaths to children under-five occur in the very first month of life with three-quarters of these deaths occurring during the first week of life. The promotion of delivery with a skilled birth attendant (SBA) is being promoted as a strategy to reduce neonatal mortality. This study explored whether SBAs had a protective effect against neonatal mortality in three different regions of the world.
Access the full abstract and journal article on the MEASURE Evaluation web site.
Thoughts?
Evaluate 
I thank the authors of this article because it just exposed the poor condition women and children find themselves in a resource poor setting. It also brings to focus issues of Health equity, Gender and human rights. But i think countries, regions and cultures should come up with a definition of minimum package of what constitutes “skills” a birth attendant should be given.
Dr. Sampson Ezikeanyi: PhD, MPH
Thanks for your comment Dr. Ezikeanyi. I think a good place to start may be thinking of the key interventions needed to prevent maternal mortality and the key interventions needed to prevent neonatal mortality and to think about these skill sets separately. Some birth attendants, for example, may have been trained in interventions needed to prevent maternal mortality but not in the interventions needed to prevent neonatal deaths. Also important would be to look at a range of skills needed for these interventions. Some attendants may have all the key skills, some have only half etc. Getting at who is really skilled will require more precise measures. The downside is that these measures likely would be difficult to capture in large scale surveys because an assessment would be required. However, such assessment would be helpful for countries in understanding gaps in skills/knowledge among their health worker population and then in taking action to further training and equipping of facilities.