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|INDICATOR 7: Proportion of births attended by skilled health personnel|
| Why this indicator? What will it measure and provide information for?
The indicator is a global measure of a health system’s ability to provide adequate care for pregnant women. Concerns have been expressed that the presence of a skilled attendant may not adequately capture women’s access to good quality care, particularly when complications arise, and information on the supplies and equipment a skilled attendant may or may not have is lacking. In some countries, information on the proportion of births in health centers/hospital may be available, which can be a useful, complementary indicator.
|What Sustainable Development Goal is the indicator connected to? This indicator is linked to SDG 3 “Ensure healthy lives and promote well-being for all at all ages” and the SDG 5 “Achieve gender equity and empower all women and girls.” It is listed as one of the indicators for tracking this SDG. Specifically this indicator is linked to the SDG3 targets “By 2030, reduce the global maternal mortality ratio to less than 70 per 100,000 live birth” and “Achieve universal health coverage, including financial risk protection, access to quality essential health-care services and access to safe, effective, quality and affordable essential medicines and vaccines for all,” as well as the SDG5 target “Ensure universal access to sexual and reproductive health and reproductive rights as agreed in accordance with the Program of Action of the International Conference on Population and Development and the Beijing Platform for Action and the outcome documents of their review conferences”|
| Definitions and key terms
Health personnel refers to personnel trained in providing life-saving obstetric care, including giving the necessary supervision, care and advice to women during pregnancy, labor and the post-partum period; conducting deliveries on their own; and caring for newborns. Traditional birth attendants, even if they receive a training course, are not included.
| Data and information required to calculate the indicator
* Numerator: number of live births to women aged 15-49 attended by a skilled health personnel during delivery
* Denominator: total live births to women aged 15-49 in the same period
| Suggested method for data collection
* This information is collected via surveys, typically DHS surveys which include standard questions for obtaining data for this indicator.
* See DHS question numbers and wording to calculate this indicator.
| Possible data sources
* Household surveys (DHS) conducted typically every 3 or 5 years. In some cases, data are available for disaggregation at sub-national level. Ministries of Health may have estimates available for regions or provinces.
* Data from national-level sources are compiled in the UNICEF global database. Latest available estimates of skilled health personnel at delivery are available on www.childinfo.org
* If feasible and appropriate, CARE may also conduct household surveys, especially if sampling to represent marginalized impact populations or specific geographic areas
| Resources needed for data collection
If the information will be gathered from secondary data sources, no investment is required for gathering this indicator at the national level. However, your evaluation may want to assess this directly in specific geographic areas or sub-populations or include questions on CARE’s contribution to the change, which will require resources for conducting interviews or focus groups.
| Reporting results for this indicator: number of people for which the change happened
* How many births were attended by skilled personal in the country/sub-nationally last year? (based on total number of births multiplied by the proportion of births attended by skilled attendants)
* Has there been an improvement of the % of births attended by skilled personal since the past measurement, has it stayed the same or worsened?
* Given CARE’s role and presence, to what extent has CARE contributed to this change and at which level (national, in a particular region or part of the country, marginally)? Please explain.
| Questions for guiding the analysis and interpretation of data (explaining the how and why the change happened, and how CARE contributed to the change)
* How has CARE contributed to the change? What were CARE’s main strategies for contributing to this change (e.g. capacity building of health staff, community awareness raising, advocacy and policy change, supporting the scale up of proven solutions, a combination of strategies, other ways)?
* Is the change in births attended by skilled personnel influenced by increased participation and representation of women in decisions related to obstetric care?
* Is the change in births attended by skilled personnel influenced by new or amended policies, legislation, programs, accountability spaces and/or budgets responsive to providing life-saving obstetric care?