Malawi 2015-16

9.4.2 Skilled Assistance during Delivery
Skilled assistance during delivery
Births delivered with the assistance of skilled providers such as doctors,
clinical officers, medical assistants, nurses, and midwives.
Sample: All live births in the 5 years before the survey
Assistance during childbirth can influence the birth
outcome and the health of the mother and the
newborn. A skilled attendant can manage
complications of pregnancy and delivery or refer the
mother and/or the baby to the next level of care. In
the 5 years before the survey, 9 in 10 live births
(90%) were delivered by a skilled provider (Table
9.6). The majority of births are attended by nurses or
midwives (68%) followed by doctors, clinical
officers, and medical assistants (22%) (Figure 9.5).
Trends: Skilled assistance during deliveries in
Malawi is increasing: the proportion of births in
health facilities assisted by a skilled provider rose
from 55% in 1992 to 90% in 2015-16.
Figure 9.5 Assistance during delivery
Traditional
birth
attendant
3%
Percent distribution of births in the 5 years
before the survey
Patient
attendant
2%
No one
2%
Relative/
friend/
other
4%
Doctor/
clinical
officer/
medical
assistant
21%
Nurse/
midwife
68%
Patterns by background characteristics
• Ninety-three percent of births to mothers who attended four or more ANC visits were delivered by a
skilled attendant compared to 62% of births to mothers with no ANC visits.
• Only 9% of births that took place outside of
health facilities were delivered by a skilled
provider.
• Births to women in urban areas (95%) are more
likely to be delivered by a skilled provider
compared with rural women (89%).
Figure 9.6 Skilled assistance at delivery
by education
Percentage of live births in the 5 years
before the survey assisted by a skilled
provider
98
95
• The mothers’ educational status is highly
correlated with skilled delivery. Ninety-eight
percent of births to mothers with more than a
secondary education were delivered by a skilled
attendant, compared with 84% of births to
mothers with no education (Figure 9.6).
9.4.3 Delivery by Caesarean
84
No
education
89
Primary Secondary More than
secondary
Access to caesarean section can reduce maternal and neonatal mortality and complications such as
obstetric fistula. However, caesarean section without a medical need can put women at risk of short and
long-term health problems. The WHO advises that caesarean section should only be done when medically
necessary, and does not recommend a target rate for countries to achieve at the population level.
The 2015-16 MDHS found that 6% of live births in the 5 years before the survey were delivered by
caesarean section (C-section). Five percent of the C-sections were decided after the onset of labour pains,
compared to the 1% that was decided before onset of labour pains (Table 9.7).
Maternal Health Care • 123