Skilled Birth Attendants: who is who? A descriptive study of definitions and roles from nine Sub Saharan African countries
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 provide...
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| Veröffentlicht in: | PloS one 2012-07, Vol.7 (7), p.e40220-e40220 |
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| creator | Adegoke, Adetoro Utz, Bettina Msuya, Sia E van den Broek, Nynke |
| description | 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.
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.
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. |
| doi_str_mv | 10.1371/journal.pone.0040220 |
| format | Article |
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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.
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.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0040220</identifier><identifier>PMID: 22808121</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject><![CDATA[Africa South of the Sahara - epidemiology ; Antibiotics ; Anticonvulsants ; Attended births ; Birth ; Births ; Childbirth & labor ; Childrens health ; Clinical Competence - legislation & jurisprudence ; Clinical Competence - standards ; Clinical Competence - statistics & numerical data ; Delivery (Childbirth) ; Delivery, Obstetric - education ; Delivery, Obstetric - legislation & jurisprudence ; Delivery, Obstetric - standards ; Delivery, Obstetric - statistics & numerical data ; Economic indicators ; Female ; Global health ; Gynecology ; Handbooks ; Health ; Health aspects ; Health care ; Health care industry ; Health Personnel - education ; Health Personnel - legislation & jurisprudence ; Health Personnel - standards ; Health Personnel - statistics & numerical data ; Health services ; Humans ; Infant mortality ; Legislation as Topic ; Literature reviews ; Maternal & child health ; Maternal mortality ; Maternal Welfare - statistics & numerical data ; Medical personnel ; Medical referrals ; Medicine ; Midwifery ; Midwifery - education ; Midwifery - legislation & jurisprudence ; Midwifery - standards ; Midwifery - statistics & numerical data ; Midwives ; Neonates ; Nurse Midwives - legislation & jurisprudence ; Nurse Midwives - standards ; Nurse Midwives - statistics & numerical data ; Obstetrics ; Physicians ; Placenta ; Pregnancy ; Primary care ; Registered nurses ; Reproductive health ; Standardization ; Stillbirth ; Surveys and Questionnaires ; Teaching methods ; Vagina]]></subject><ispartof>PloS one, 2012-07, Vol.7 (7), p.e40220-e40220</ispartof><rights>COPYRIGHT 2012 Public Library of Science</rights><rights>2012 Adegoke et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License: https://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>Adegoke et al. 2012</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c758t-d3fb8cd06ec557023082080af956011c83cb826562c6c7c1e009d14e7007580f3</citedby><cites>FETCH-LOGICAL-c758t-d3fb8cd06ec557023082080af956011c83cb826562c6c7c1e009d14e7007580f3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3393745/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3393745/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,2102,2928,23866,27924,27925,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22808121$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Miranda, J. Jaime</contributor><creatorcontrib>Adegoke, Adetoro</creatorcontrib><creatorcontrib>Utz, Bettina</creatorcontrib><creatorcontrib>Msuya, Sia E</creatorcontrib><creatorcontrib>van den Broek, Nynke</creatorcontrib><title>Skilled Birth Attendants: who is who? A descriptive study of definitions and roles from nine Sub Saharan African countries</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>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.
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.
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.</description><subject>Africa South of the Sahara - epidemiology</subject><subject>Antibiotics</subject><subject>Anticonvulsants</subject><subject>Attended births</subject><subject>Birth</subject><subject>Births</subject><subject>Childbirth & labor</subject><subject>Childrens health</subject><subject>Clinical Competence - legislation & jurisprudence</subject><subject>Clinical Competence - standards</subject><subject>Clinical Competence - statistics & numerical data</subject><subject>Delivery (Childbirth)</subject><subject>Delivery, Obstetric - education</subject><subject>Delivery, Obstetric - legislation & jurisprudence</subject><subject>Delivery, Obstetric - standards</subject><subject>Delivery, Obstetric - statistics & numerical data</subject><subject>Economic indicators</subject><subject>Female</subject><subject>Global health</subject><subject>Gynecology</subject><subject>Handbooks</subject><subject>Health</subject><subject>Health aspects</subject><subject>Health care</subject><subject>Health care industry</subject><subject>Health Personnel - education</subject><subject>Health Personnel - legislation & jurisprudence</subject><subject>Health Personnel - standards</subject><subject>Health Personnel - statistics & numerical data</subject><subject>Health services</subject><subject>Humans</subject><subject>Infant mortality</subject><subject>Legislation as Topic</subject><subject>Literature reviews</subject><subject>Maternal & child health</subject><subject>Maternal mortality</subject><subject>Maternal Welfare - statistics & numerical data</subject><subject>Medical personnel</subject><subject>Medical referrals</subject><subject>Medicine</subject><subject>Midwifery</subject><subject>Midwifery - education</subject><subject>Midwifery - legislation & jurisprudence</subject><subject>Midwifery - standards</subject><subject>Midwifery - statistics & numerical data</subject><subject>Midwives</subject><subject>Neonates</subject><subject>Nurse Midwives - legislation & jurisprudence</subject><subject>Nurse Midwives - standards</subject><subject>Nurse Midwives - statistics & numerical data</subject><subject>Obstetrics</subject><subject>Physicians</subject><subject>Placenta</subject><subject>Pregnancy</subject><subject>Primary care</subject><subject>Registered nurses</subject><subject>Reproductive health</subject><subject>Standardization</subject><subject>Stillbirth</subject><subject>Surveys and Questionnaires</subject><subject>Teaching methods</subject><subject>Vagina</subject><issn>1932-6203</issn><issn>1932-6203</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>DOA</sourceid><recordid>eNqNk99v0zAQxyMEYmPwHyCwhITgoeVsx3GyB1CZ-FFp0iQKvFqu7bQuqV1sZzD-etw1m1q0B5SHiy6f7_d8F19RPMUwxpTjNyvfBye78cY7MwYogRC4VxzjhpJRRYDe33s_Kh7FuAJgtK6qh8URITXUmODj4s_sh-06o9F7G9ISTVIyTkuX4in6tfTIxm14hyZIm6iC3SR7aVBMvb5Cvs3J1jqbrHcRSadR8J2JqA1-jZx1Bs36OZrJpQzSoUkbrMpR-d6lYE18XDxoZRfNkyGeFN8-fvh69nl0fvFpejY5HynO6jTStJ3XSkNlFGMcCIWaQA2ybVgFGKuaqnlNKlYRVSmusAFoNC4NB8h6aOlJ8Xznu-l8FMPYosCUMNqUjJSZmO4I7eVKbIJdy3AlvLTiOuHDQsiQrOqMkJrNMcYsVyIlA1Y3hDPCSsWplLqG7PV2qNbP10Yrk5uV3YHp4Rdnl2LhLwWlDeUlywavBoPgf_YmJrG2UZmuk874Pp8bCIeSkIZn9MU_6N3dDdRC5gasa32uq7amYlJyjjEt-bbs-A4qP9qsrcp3rLU5fyB4fSDITDK_00L2MYrp7Mv_sxffD9mXe-zSyC4to-_661t2CJY7UAUfYzDt7ZAxiO2K3ExDbFdEDCuSZc_2f9Ct6GYn6F8abQoR</recordid><startdate>20120710</startdate><enddate>20120710</enddate><creator>Adegoke, Adetoro</creator><creator>Utz, Bettina</creator><creator>Msuya, Sia E</creator><creator>van den Broek, Nynke</creator><general>Public Library of Science</general><general>Public Library of Science (PLoS)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>IOV</scope><scope>ISR</scope><scope>3V.</scope><scope>7QG</scope><scope>7QL</scope><scope>7QO</scope><scope>7RV</scope><scope>7SN</scope><scope>7SS</scope><scope>7T5</scope><scope>7TG</scope><scope>7TM</scope><scope>7U9</scope><scope>7X2</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABJCF</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>D1I</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB.</scope><scope>KB0</scope><scope>KL.</scope><scope>L6V</scope><scope>LK8</scope><scope>M0K</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>M7S</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PATMY</scope><scope>PDBOC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PTHSS</scope><scope>PYCSY</scope><scope>RC3</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope></search><sort><creationdate>20120710</creationdate><title>Skilled Birth Attendants: who is who? 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Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Adegoke, Adetoro</au><au>Utz, Bettina</au><au>Msuya, Sia E</au><au>van den Broek, Nynke</au><au>Miranda, J. Jaime</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Skilled Birth Attendants: who is who? A descriptive study of definitions and roles from nine Sub Saharan African countries</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2012-07-10</date><risdate>2012</risdate><volume>7</volume><issue>7</issue><spage>e40220</spage><epage>e40220</epage><pages>e40220-e40220</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>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.
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.
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.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>22808121</pmid><doi>10.1371/journal.pone.0040220</doi><tpages>e40220</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1932-6203 |
| ispartof | PloS one, 2012-07, Vol.7 (7), p.e40220-e40220 |
| issn | 1932-6203 1932-6203 |
| language | eng |
| recordid | cdi_plos_journals_1325394524 |
| source | MEDLINE; DOAJ Directory of Open Access Journals; Public Library of Science (PLoS) Journals Open Access; EZB-FREE-00999 freely available EZB journals; PubMed Central; Free Full-Text Journals in Chemistry |
| subjects | Africa South of the Sahara - epidemiology Antibiotics Anticonvulsants Attended births Birth Births Childbirth & labor Childrens health Clinical Competence - legislation & jurisprudence Clinical Competence - standards Clinical Competence - statistics & numerical data Delivery (Childbirth) Delivery, Obstetric - education Delivery, Obstetric - legislation & jurisprudence Delivery, Obstetric - standards Delivery, Obstetric - statistics & numerical data Economic indicators Female Global health Gynecology Handbooks Health Health aspects Health care Health care industry Health Personnel - education Health Personnel - legislation & jurisprudence Health Personnel - standards Health Personnel - statistics & numerical data Health services Humans Infant mortality Legislation as Topic Literature reviews Maternal & child health Maternal mortality Maternal Welfare - statistics & numerical data Medical personnel Medical referrals Medicine Midwifery Midwifery - education Midwifery - legislation & jurisprudence Midwifery - standards Midwifery - statistics & numerical data Midwives Neonates Nurse Midwives - legislation & jurisprudence Nurse Midwives - standards Nurse Midwives - statistics & numerical data Obstetrics Physicians Placenta Pregnancy Primary care Registered nurses Reproductive health Standardization Stillbirth Surveys and Questionnaires Teaching methods Vagina |
| title | Skilled Birth Attendants: who is who? A descriptive study of definitions and roles from nine Sub Saharan African countries |
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