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Skilled delivery attendance

In Sierra Leone, women from the richest quintile are three times as likely as those from the poorest to be attended by a skilled health professional.

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In West and Central Africa, only 46 per cent of women in the region who give birth are attended at delivery by skilled health personnel

Urban women are twice as likely as rural women to give birth with skilled health personnel in attendance, and in Chad they are eight times as likely.

The disparities based on household wealth are even greater. In 16 countries with these data, women from the richest quintile are three and a half times as likely as those from the poorest to be attended by a skilled health professional. Again, the disparity is greatest in Chad, where only 1 per cent of the poorest women are attended, compared with 48 per cent of the wealthiest women.

Better access to skilled personnel during pregnancy and at delivery coud prevent hundred of thousands mothers death.

Progress is made, yet it is insufficient

There has been some progress during recent years, although it is not yet reflected in the overall maternal mortality ratio. The percentage of births attended by skilled personnel in the region as a whole increased from 37 per cent to 46 per cent over the 1995–2006 period, representing one of the largest regional improvements in coverage in the world. Benin, Burkina Faso, Côte d’Ivoire and Togo have made notable strides, increasing their coverage by at least 10 percentage points and currently reaching more than half of all births with skilled attendance.

Emergency obstetrics care
Lack of access to emergency obstetrics care remains a grave problem. In 15 of 16 countries with data, less than 5 per cent of rural women delivered via Caesarean section, indicating that this potentially life-saving procedure is still unavailable to many rural women.

Haemorrhage is the leading cause of maternal death in Africa

Causes of maternal death (1997-2002) in Africa
Source: Progress for children 7 (UNICEF, September 2008)

Post-partum care is also overlooked
According to recent data from Burkina Faso, Cameroon, Ghana and Niger, the majority of women who do not give birth in a clinic or hospital do not receive a post-partum check-up; even among the minority who do, less than half are seen during the 24 hours following delivery, the period when most complications occur.

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Photo Essay | Reportage photos

Sierra Leone : one of the riskiest place to give birth in the world | Sierra Leone: un pays dangereux pour donner la vie (en anglais)

[View photo essay]

Resources

•A continuum of care for maternal, newborn and child health
•The report card for the region
•Antenatal care
•Skilled attendance at delivery
•Causes of maternal deaths
•Facts on maternal deaths
•Key statistics

Publications

•The State of the World's Children 2009: Maternal and Newborn Health | La situation des enfants dans le monde 2009: Mortalité maternelle et néonatale
•Progress for Children 7: a report card on maternal mortality | Progrès pour les enfants 7: bilan statistique sur la mortalité maternelle
•Countdown to 2015: Report 2008