Skilled birth attendance
Professional care at birth by doctors, nurses, auxiliary nurses or other allied health professionals – skilled birth attendance – helps reduce complications during childbirth that can lead to maternal disability and death. Yet in urban areas of 44 low- and middle-income countries for which data are available, skilled birth attendance varies from a low of less than 40% to a high of 100%. The majority of the studied countries have skilled birth attendance coverage of less than 90% in the urban areas. Across the regions of Africa, the Americas and Asia, large gaps exist in skilled birth attendance between the richest and the poorest urban residents. This relationship also holds true within countries. For example, in Bangladesh, skilled birth attendance coverage is 6% among the poorest fifth of the urban population while it is more than 75% among the richest fifth.
Around the world, the proportion of births attended by a skilled health worker improved between 1990 and 2006, though still falling short of the 100% target. Improvements were made in almost all regions, except in Europe, where coverage levels were already high in 1990. Very little progress has been made in urban areas of Africa, the Americas and Asia with respect to skilled birth attendance. At current rates of progress, 78% of the studied low- and middle-income countries in Africa, the Americas and Asia will not achieve even 90% coverage of skilled birth attendance for the poorest 20% of urban women. The situation is even more dire in 38% of the same countries, where fewer than half of the poorest women in urban areas will have access to skilled birth attendance in 2015, according to current rates of progress.