Skilled birth attendance in Sierra Leone, Niger, and Mali : analysis of demographic and health surveys

Edward Kwabena AMEYAW*, Kwamena Sekyi DICKSON

*Corresponding author for this work

Research output: Journal PublicationsJournal Article (refereed)peer-review

22 Citations (Scopus)


Background: Skilled birth attendance (SBA) is a key strategy for averting maternal mortality ratio (MMR). The lifetime risk of maternal death is high in countries with low SBA. With the presence of a skilled birth attendant, the possibility of death owing to intrapartum-related complications or stillbirth can be reduced by 20%. 

Methods: Using data from the most recent Demographic and Health Surveys, we investigated the prevalence of skilled birth attendance, variations, and associated factors. The sample was drawn from women aged 15-49 who were surveyed in these countries as part of the Demographic and Health Survey (DHS) program. With multivariate logistic regression, we explored the socio-demographic factors that predict women's likelihood of seeking skilled birth attendance or otherwise. 

Results: Less than half of the women in Niger, Sierra Leone, and Mali obtained skilled birth attendance, with the worst case occurring in Niger (32.6%). Women in rural areas have less likelihood of obtaining skilled birth attendance (OR 0.21; 95% CI 0.16-0.28), as compared to women in urban locations. Highly educated women (OR 2.50; 95% CI 0.72-8.69), those who had subscribed to health insurance (OR 1.39; 95% CI 0.88-2.20), those who obtain four or more antenatal care visits (OR 1.63; 95% CI 1.43-1.86), and women who watch television at least once a week (OR 2.33; 95% CI 1.88-2.88) are more probable to seek SBA. 

Conclusion: Interventions to increase SBA rates in these countries need to be reassessed to focus on the rural-urban disparity in healthcare, female education, and ANC attendance.

Original languageEnglish
Article number164
Number of pages10
JournalBMC International Health and Human Rights
Issue number1
Publication statusPublished - 3 Feb 2020
Externally publishedYes

Bibliographical note

Publisher Copyright:
© 2020 The Author(s).


  • Mali
  • Niger
  • Sierra Leone
  • Skilled birth attendance
  • Women


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