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WHO Bulletin Publishes Results of QAP Skilled Birth Attendant Study

The Bulletin of the World Health Organization selected the article, “Are skilled birth attendants really skilled? A measurement method, some disturbing results and a potential way forward,” for inclusion in its special Maternal Health theme issue published this month to coincide with the Women Deliver Conference held in London October 18-20.  The article was written by Steven A Harvey (QAP), Yudy Carla Wong Blandón (QAP/Nicaragua), Affette McCaw-Binns (University of the West Indies), Ivette Sandino (UNICEF/Nicaragua), Luis Urbina, César Rodríguez, Ivonne Gómez (all of QAP/Nicaragua), Patricio Ayabaca (QAP/Ecuador), Sabou Djibrina (UNICEF/Nicaragua), and the Nicaraguan maternal and neonatal health quality improvement group.

Although delivery by a skilled birth attendant (SBA) serves as an indicator of progress towards reducing maternal mortality worldwide and is tracked by the World Health Organization and other agencies, little is known about the competence of SBAs to manage common, life-threatening obstetric complications. The article describes research conducted by QAP to assess SBA competence in five high maternal mortality settings as a basis for initiating quality improvement activities.  Under the first phase of the QAP study, 166 SBAs were tested in Benin, Ecuador, Jamaica and Rwanda.  In the second phase, the earlier results were used to refine the research instruments and conduct a subsequent evaluation of 1,358 SBAs throughout Nicaragua.

The study concluded that a wide gap exists between current evidence-based standards and provider competence to manage selected obstetric and neonatal complications. In the article, the authors discuss the significance of that gap, suggest approaches to close it and describe efforts to do so currently underway in Ecuador, Nicaragua and Niger.

The article can be accessed online at http://www.who.int/bulletin/volumes/85/10/en/index.html
For more information on QAP’s research on SBA competency, please contact Dr. Steven Harvey at sharvey@urc-chs.com.


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The Quality Assurance Project (QAP) is funded by the U.S. Agency for International Development
(USAID) under Contract Number GPH-C-00-02-00004-00.