Can skilled attendance at delivery reduce maternal mortality in developing countries

Summary This paper explores the scientific justification for the key action message “ensure skilled attendance at delivery.” Many governments and other provider agencies in poor countries will need to commit additional health resources in order to respond to this message, and opportunity costs will be incurred. Achieving targets will take time, and benefits in terms of maternal mortality may not be detected for several years. It is therefore crucial to review the basis for prioritising skilled attendance. This paper examines the historical and epidemiological evidence at both the individual and population levels of analysis. The lack of a clear definition has been, and continues to be, the cause of much confusion over the role, and thus the potential, of skilled…