Are skilled birth attendants really skilled? A measurement method, some disturbing results and a potential way forward
Steven A Harvey, Yudy Carla Wong Blandón, Affette McCaw-Binns, Ivette Sandino, Luis Urbina, César Rodríguez, Ivonne Gómez, Patricio Ayabaca, Sabou Djibrina, the Nicaraguan maternal and neonatal health quality improvement group
Volume 85, Number 10, October 2007, 783-790
Table 2. Number of Phase II participants by evaluation component and professional cadre
| Professionalcadre | Knowledge component |
Skills component |
|||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|
| Total | Obstetric/gynaecologic test | Paediatric test | General test | Partograph exercise | Active management | Manual removal | Bimanual compression | Immediate newborn care | Neonatal resuscitation | ||
| Obstetrician/gynaecologist | 82 | 82 | – | – | 79 | 49 | 49 | 49 | – | – | |
| Paediatrician | 82 | – | 82 | – | – | – | – | – | 48 | 48 | |
| Obstetric/gynaecologic resident | 41 | 41 | – | – | 38 | 16 | 16 | 16 | – | – | |
| Paediatric resident | 27 | – | 27 | – | – | – | – | – | 9 | 9 | |
| General practitioner – gynaecologist | 35 | 35 | – | – | 34 | 20 | 20 | 20 | – | – | |
| General practitioner – paediatrician | 40 | – | 40 | – | – | – | – | – | 18 | 18 | |
| General practitioner – ER | 199 | 1 | – | 198 | 192 | 85 | 85 | 85 | 84 | 84 | |
| Social service physician | 91 | 3 | 2 | 86 | 89 | 36 | 36 | 36 | 33 | 33 | |
| Medical intern | 57 | 25 | 29 | 3 | 27 | 5 | 5 | 5 | 7 | 7 | |
| Nurse-midwifea | 5 | 4 | – | 1 | 5 | 3 | – | – | – | – | |
| Maternal and child health nurse | 68 | 37 | 16 | 15 | 34 | 27 | – | – | 16 | 16 | |
| Professional nurse | 266 | 55 | 67 | 144 | 79 | 63 | – | – | 71 | 71 | |
| Technical nurse | 20 | 6 | 7 | 7 | 4 | 2 | – | – | 2 | 2 | |
| Auxiliary nurse | 345 | 46 | 51 | 248 | 85 | 79 | – | – | 81 | 81 | |
ER, emergency room.a Nurse-midwives have received both nursing and midwifery training, and therefore theoretically belong in a separate category from nurses. However, Nicaragua no longer trains this cadre and very few remain in practice. Since our sample contained only five nurse-midwives (< 0.5% of total), we grouped them with professional nurses.