Academic journal article International Family Planning Perspectives

"Skilled" Birth Attendants May Lack Needed Expertise

Academic journal article International Family Planning Perspectives

"Skilled" Birth Attendants May Lack Needed Expertise

Article excerpt

The competence of skilled birth attendants may not be up to international clinical standards, according to a study of 1,358 providers responsible for deliveries (i.e., doctors, medical students, and professional and auxiliary nurses) at qualified basic or comprehensive emergency obstetric care facilities throughout Nicaragua. (1) Overall, these providers correctly answered 62% of test questions assessing their knowledge of such topics as infection prevention and active management of third-stage labor. Results, however, varied by topic: For example, providers correctly answered 80% of questions about hemorrhage during pregnancy, but only 16% of those pertaining to infection prevention. Knowledge scores varied by type of provider as well, with doctors and medical students answering more questions correctly (72% and 68%, respectively) than professional or auxiliary nurses:, 57% and 51%). Similarly, in evaluations of providers' skill in using a partograph (a chart used to track the progress of a delivery) and completing certain clinical procedures (e.g., manual removal of the placenta and neonatal resuscitation), doctors were found to be the most competent, followed by medical students, professional nurses and then auxiliary nurses; however, even doctors' scores were low for certain skills. …

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