Overview of Health Workforce providing delivery care in West African French-speaking Countries / 国際保健医療

ABSTRACT

<b>Objective</b><BR>  In West African countries where the maternal mortality rate is high compared to the rest of the world, international assistance is conducted actively to improve the birth rate with the presence of Skilled Birth Attendant (SBA). However, few documents describe which workforces are considered as SBA and which work in delivery care actually on site. This paper summarizes the workforce engaged in delivery care and clarifies which are the occupations considered as SBA in West African French-speaking countries. <BR><b>Method</b><BR>  Literature review was conducted based on information from official documents related to health workforce in 7 West African French-speaking countries Benin, Burkina Faso, Ivory Coast, Mali, Niger, Senegal and Togo, and the respective governmental websites. To determine the professional categories as SBA in each country, Demographic and Health Survey (DHS) was referred.<BR><b>Result</b><BR>  This research reveals that the workforces which engage in delivery care in the target countries are nurse, midwife, auxiliary nurse, auxiliary midwife, paramedical personnel, obstetric nurse, primary medical staff, matron, community health worker and traditional birth attendants. Titles and definitions of health workforce however vary in official documents issued by the government even of one country. In DHS Report, nurse and midwife are considered as SBA in all countries, but other professional categories vary in each country. In many countries, professional nurse and midwife categorized by WHO are included in SBA, while community health worker is not. Matron, which is a kind of community health worker, is considered as SBA exceptionally in Burkina Faso and Mali.<BR><b>Conclusion</b><BR>  None of the countries clearly define which professional categories are considered as SBA in official documents. Urgent definition of SBA is required and simultaneously the management system of health workforce and its uniformity for description in documents are needed. It is also suggested that various SBA-related policy assistance for the reduction of the maternal mortality are conducted without clear definition of SBA in each country. Thus it is reaffirmed that the policy assistance must be planned with adequate understanding in health workforce, based on appropriate selections of workers and well considered methods of intervention in the concerned field.