Skilled attendance at delivery; how skilled are institutional birth attendants? : An explorative study on birth attendants at Bansang Hospital, The Gambia

Abstract

Abstract Background: As reflected in the United Nations Millennium Development Goals (UN MDG 5), reducing maternal mortality represents an important area of concern. The common causes of maternal deaths may be preventable and treatable by having access to emergency obstetric care (EmOC), including skilled birth attendance (SBA), when needed. Measuring the presence of a birth attendant has been the main focus until now, not their skills and qualifications, and by this we cannot presuppose that they are skilled in delivery care. We explored the subjective level of confidence in skills and abilities defined by the WHO, among the birth attendants at Bansang Hospital, The Gambia, and how work conditions affected their practice.

Methods: This study is exploratory in nature. We used a structured interview to investigate specific skills, and added a qualitative component.

Results: Our results show that there is a difference between the self reported skills and abilities among the untrained and trained birth attendants. Formal education makes you feel more confident in performing the procedures expected from a SBA. The majority felt the need for additional training, especially in EmOC procedures. Our study also reveals several problems concerning management, material and human resources.

Conclusion: There is a need for further examinations to objectively measure the skills and abilities of the birth attendants in The Gambia. Knowledge is needed on how to increase the quality and capacity of pre- and in-service training among birth attendants in order to reach future goals of every woman having access to skilled birth attendance.