SKILLED HEALTH PERSONNEL ATTENDED DELIVERY AS A PROXY INDICATOR FOR MATERNAL AND PERINATAL MORTALITY A SYSTEMATIC REVIEW

Abstract

BACKGROUND: Several demographic and health surveys in Africa have shown the high prevalence ofhome delivery, but little is known how strongly skilled person unattended deliveries are associated withmaternal and perinatal mortality. The aim of this review was to assess the gross correlation of maternalmortality ratios (MMR) and perinatal mortality rates (PMR) with the proportion of skilled healthpersonnel attended deliveriesMETHODS: In this study, a systematic review was conducted after a computer based literature searchwas run in the electronic databases from 1990 through September 2013. Bivariate linear regressionanalyses were done for the proportion of skilled person attended deliveries in relation with MMR,stillbirth and neonatal mortality rates using national survey data of 41 African countries.RESULTS: African countries with relatively small population sizes and with middle to high income werefound to have above 90% skilled person attended deliveries. Several African countries with a highproportion of skilled person attended deliveries (60%-100%) were able to reduce the MMR to the rangeof 56-370/100,000 live births. Several Sub Saharan African (SSA) countries were far from their northerncounterparts. The regression analyses demonstrated a negative correlation of the proportion of skilledhealth personnel attended deliveries with the MMR, stillbirth rate and neonatal mortality rate.CONCLUSION: According to the national data of the included African countries, skilled deliveryattendance was associated with significant reduction of maternal, fetal and neonatal mortality. SSAcountries need to benchmark the experience of the North African countries to reduce the high maternaland perinatal deaths.