Skilled Attendance at Delivery: A Comparative Study of Trends in Delivery Care in Six Developing Countries

Sian Curtis, University of North Carolina at Chapel Hill
Jacqueline Bell, University of Aberdeen
Silvia Alayon, Macro International Inc.

Prioritization of skilled attendance at delivery is a recent strategy for the improvement of maternal health. The purpose of this paper is to provide a better understanding of trends in delivery care across a range of developing countries. It involves a detailed secondary analysis of data from Demographic and Health Surveys (DHS) in Bangladesh, Bolivia, Ghana, Indonesia, Malawi, and the Philippines. Delivery with a health professional (DHP) has increased over the last decade in all six countries, with the largest absolute increases observed in Bolivia and Indonesia (14.6 and 13.4 percentage points) and the lowest observed in Malawi (0.4 percentage points). Increases in DHP have been more pronounced among low parity women leading to widening parity differentials over time. Differentials by poverty quintile are also large and there is generally evidence that DHP is improving more slowly in the poorest quintile of the population resulting in widening poverty differentials.