Midlevel providers and the Fifth Millennium Goal of reducing maternal mortality.
The implementation of community midwifery, characterized by a health system approach, political commitment, task-shifting, close supervision and complimentary roles of midwives and doctors, was a major contributor to the decline in maternal and neonatal mortality in Sweden during the late 19th century. In respect of the MDG5 a causal inference between skill birth attendants and decline in maternal mortality might not be straight forward but more a matter of skilled birth attendance, i.e. obstetricians, professional midwives, other midlevel providers and nurse-aides working in an enabling environment. A health system approach, commitment and mobilization, is a necessity to achieve safe abortions and safe deliveries by full coverage and equity.
Department of Obstetrics & Gynecology, Epidemiology and Public Health, Umeå University Hospital, SE-901 87 Umeå, Sweden. Ulf.hogberg@obgyn.umu.se
Ulf
U
Högberg
D017954:Africa South of the Sahara / Q000453:epidemiology; D001211:Asia, Western / Q000453:epidemiology; D003906:Developing Countries / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008427:Maternal Health Services; D008428:Maternal Mortality; D008880:Midwifery / Q000193:education; D011247:Pregnancy; D013548:Sweden / Q000453:epidemiology; D000078329:Workforce