Indicator 3.1.2 Proportion of births attended by skilled health personnel

Goal 3: Ensure healthy lives and promote well-being for all at all ages 

Target 3.1: By 2030, reduce the global maternal mortality ratio to less than 70 per 100,000 live births

Indicator 3.1.2: Proportion of births attended by skilled health personnel

November 2021

Related to Target 3.1 on reducing maternal mortality, 3.2 on reducing neonatal mortality and 3.8 on achieving universal health coverage (coverage of essential health services).

Uganda Bureau of Statistics (UBOS)

Uganda Bureau of Statistics (UBOS)

Johnstone Galande

Department of Demography and Social Statistics

Senior Demographer

+256 782 789787

P.O Box 7186, Kampala

galandej1@gmail.com

Definition: 

The number of births attended by skilled health personnel (doctor, nurse or midwife) trained in providing quality obstetric care, including giving the necessary support and care to the mother and the newborn during childbirth and immediate postpartum period expressed as a percentage of the total number of live births in the same period. According to the current definition (1) these are competent maternal and newborn health (MNH) professionals educated, trained and regulated by national and international standards. They are competent to: (i) provide and promote evidence-based, human-rights based, quality, socio-culturally sensitive and dignified care to women and newborns; (ii) facilitate physiological processes during labour and delivery to ensure a clean and positive childbirth experience; and (iii) identify and manage or refer women and/or newborns with complications.

Percent

None

The Uganda Demography and Health Survey (UDHS)

Sample Design:

The sample design for the 2016 UDHS used the sampling frame from the Uganda National Population and Housing Census (NPHC 2014).The census frame is a complete list of all census Enumeration Areas (EAs) created for the 2014 NPHC. In Uganda, an EA is a geographic area that covers an average of about 130 households. At the time of the NPHC, Uganda was divided administratively into 112 districts, which were grouped for this survey into 15 regions. The sample for the 2016 UDHS was designed to provide estimates of key indicators for the country as a whole, for urban and rural areas separately, and for each of the 15 sub regions. Estimates are also presented for three special areas: the Lake Victoria islands, the mountainous districts, and greater Kampala. The 2016 UDHS sample was stratified and selected in two stages. In the first stage, 697 EAs were selected from the 2014 NPHC, 162 EAs in urban areas and 535 in rural areas. Households constituted the second stage of sampling. A listing of households was compiled in each of the 696 accessible selected EAs from April to October 2016. To minimize the task of household listing, each large EA (that is to say more than 300 households) selected for the 2016 UDHS was segmented. Only one segment was selected for the survey with probability proportional to segment size, and the household listing was conducted only in the selected segment. Out of the 20,880 selected households (30 households per EA), 18,506 women aged 15-49 were successfully interviewed. All women age 15-49 who were either permanent residents of the selected households or visitors who stayed in the household the night before the survey were eligible to be interviewed. In one-third of the sampled households, all men age 15-54, including both usual residents and visitors who stayed in the household the night before the interview, were eligible for individual interviews.

Recruitment and Training:

UBOS recruited and trained field staff to serve as supervisors, CAPI managers, interviewers, health technicians, and reserve interviewers for the main fieldwork. Health technicians were trained separately from interviewers. A two-day f ield practice was organized to provide trainees with additional hands on practice before the actual fieldwork. Prior to the main field work, a pre-test was conducted and best practices were adopted.

Questionnaires:

Four questionnaires were used for the 2016 UDHS: The Household Questionnaire, the Woman’s Questionnaire, the Man’s Questionnaire, and the Biomarker Questionnaire. The questionnaires, based on The DHS Program’s model questionnaires, were adapted to reflect the population and health issues relevant to Uganda. Input was solicited from all stakeholders such as; Government Ministries and Agencies, Non-governmental Organizations, and Development partners. After the finalization of the questionnaires in English, they were then translated into eight major local languages. The Household, Woman’s, and Man’s Questionnaires were programmed into a computer-assisted personal interviewing (CAPI) application for data collection purposes.

Data collection:

Data collection was conducted by 21 field teams, each consisting of one team leader, one field data Manager, three female interviewers, one male interviewer, one health technician, and a driver. The health technicians were responsible for anthropometric measurements, blood sample collection for Hemoglobin and malaria testing, and DBS specimen collection for vitamin A testing. The, interviewers used tablets to record all questionnaire responses during the interviews. The tablets were equipped with Bluetooth technology to enable remote electronic transfer of files, such as assignments from the team supervisor to the interviewers, individual questionnaires among survey team members, and completed questionnaires from interviewers to team supervisors. The field supervisors transferred data to the central data processing office via Internet File Streaming System (IFSS). Senior staff from the Makerere University School of Public Health, the Ministry of Health, and UBOS and a survey technical specialist from the DHS Program coordinated and supervised fieldwork activities. Data collection took place over a 6-month period from June 2016 through December 2016.

Every 5 years

2022

Uganda Bureau of Statistics

Uganda Bureau of Statistics and ICF

The Uganda Bureau of Statistics (UBOS) Act, 1998 provides for the development and maintenance of a National Statistical System (NSS) to ensure collection, analysis and publication of integrated, relevant, reliable and timely statistical information. It established the Bureau as the coordinating, monitoring and supervisory body for the National Statistical System.

Having a skilled health care provider at the time of childbirth is an important lifesaving intervention for both women and newborns. Not having access to this key assistance is detrimental to women’s and newborns health because it could cause the death of the women and/or the newborn or long-lasting morbidity. Achieving universal coverage for this indicator is therefore essential for reducing maternal and newborn mortality. Lack of training and an enabling environment often hinder evidence-based management of common obstetric and neonatal complications.

Births attended by skilled health personnel is an indicator of health care utilization. It is a measure of the health system’s functioning and potential to provide adequate coverage for childbirth. On its own, however, this indicator does not provide insight into the availability or accessibility of services, for example in cases where emergency care if needed. Neither does this indicator capture the quality of care received. Data collection and data interpretation in many countries is challenged by lack of guidelines, standardization of professional titles and functions of the health care provider, and in some countries by task-shifting.

Numerator:

Number of births attended by skilled health personnel (doctor, nurse or midwife) trained in providing quality obstetric care, including giving the necessary support and care to the mother and the newborn during childbirth and immediate postpartum period.

Denominator: The total number of live births in the same period (last five years).

A wide consultative process is undertaken to compile, assess and validate data on the indicator. The consultation process solicited feedback directly from other Government Agencies responsible for official statistics, on the compilation of the indicators, including the data sources used, and the application of internationally agreed definitions, classification and methodologies to the data from that source. The results of this Indicator consultation are reviewed by Ministry of Health and UNICEF

None

1. The survey implementation is overseen by a Technical Working Group which is constituted using a multi sectorial approach.

2. The survey report is reviewed by an experienced team at Management level who are in most cases Directors or Heads of departments and key stakeholders from Makerere School of Public Health, Molecular Laboratory of Makerere University School of Health Sciences, Ministry of Health and later reviewed by consultants  

The UDHS goes through several stages before production and sharing of the final findings. During the Survey implementation. i. A comprehensive training exercise is organized for all survey staff before deployment.

ii. ICF International provided consultants to oversee the UDHS iii. The survey and sampling design generated using scientific methods as recommended by the Census and Survey Rules and Regulations.

iv. Debriefing meetings are implemented for field staff at agreed intervals to address both operational and technical field challenges.

v. Senior Supervision is conducted during data collection to ensure that quality data is collected.

vi. Field Data editing, Secondary data cleaning and coding is undertaken before analysis and report writing

Before dissemination, the report is reviewed and quality assured by a professional team of consultants and Makerere University School of Public Health conducts quality assessment checks on the report. Quality Control is addressed at all levels during Survey implementation and reporting.

Data Availability:

Data available Every 5 years

Time Series:

There is data for 2001,2006 and 2011

Disaggregation: By age-group, location (Rural-Urban), 15 sub regions

Not applicable

: Uganda Demographic and Health Survey 2016 [FR333] (ubos.org) https://dhsprogram.com