The largest threat of maternal mortality occurs during labor, birth and the 24 hours following birth. Many of the interventions known to save the lives of women and their newborns depend upon the presence of a skilled birth attendant (SBA). This health professional must be accredited– such as a midwife, doctor or nurse –and have been educated and trained to proficiency in the skills needed to manage normal (uncomplicated) pregnancies, childbirth and the immediate postnatal period, and in the identification, management and referral of complications in women and newborns. The need to increase women’s access to SBAs is highlighted by the fact that MDG 5 – to improve maternal health by decreasing the maternal mortality ratio by 75% by 2015 – includes as an indicator the proportion of births attended by skilled health personnel.
 
Key MCHIP Skilled Birth Attendants Activities
Pre-Service Education
MCHIP is participating in a USAID-led activity to evaluate the Agency’s investments in pre-service education (PSE) of midwives that took place in Ethiopia, Ghana and Malawi under the ACCESS Program. The results and recommendations from this evaluation will help to inform the scope of future efforts in PSE by MCHIP and other USAID-funded global and field-based programs.

Postpartum and Postnatal Care Guidelines
MCHIP technical staff have provided input to WHO’s Making Pregnancy Safer Division regarding the revision of guidelines for provision of Postpartum and Postnatal Care (PPC/PNC). It is anticipated that these guidelines will address the care of women in facilities by skilled providers and will thus be valuable for this group. However, PPC/PNC guidelines would also be of value for those who care for women who give birth outside of facilities, the majority without skilled providers. Thus, MCHIP is undertaking the development of harmonized guidelines for PPC/PNC to assist both skilled providers in facilities as well as community-based providers who visit mothers and newborns in their homes to provide key evidence-based interventions.