Human Resources for Health in Maternal, Neonatal and - HRH ...

PHEs. In the Pacific the density of midwives to population is low as illustrated in the table
below with all countries having densities below 1 per 1000 population. The density of nurses
appears to be somewhat higher with countries such as the Fiji, Solomon Islands, Palau,
Vanuatu just on or below the 2.3 density mark.
Figure 16 Density of health workers (doctors, nurses and midwives) in the Pacific
(Halcomb 2007)
The International Confederation of Midwives (ICM) and the International Federation of
Gynecology and Obstetrics (FIGO) have proposed a target of one person with midwifery
skills for every 5,000 people, assuming that the attendant is only providing obstetric care. In a
developing country setting, this would translate into one skilled attendant assisting at 200
births every year (FCI 2002). Progress towards the skilled birth attendance indicator of 80%
at 2005 globally and 40% in countries with high MMR under MGD 5 (UNCPD 1999) shows
varying results across countries. Figure 17 outlines the trends of proportion of births attended
by skilled attendant from 1990 to 2005 by country in the SEARO region. Most of the
countries are making progress, although some need more accelerated progress. Bangladesh
and Nepal had the proportion of less than 20% SBA in 2005, while Timor-Leste had 32%,
Bhutan 52% and India 54%. For countries with a very low proportion of deliveries assisted
by skilled attendants usually the major problem is lack of SBAs at the community level.
Often, the existing health-care providers for MNH at community level do not have the
required skills, essential equipment/support and back-up referral services (Suchaxaya 2009).
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