More than half of all births take place in the absence of trained medical staff in many parts of the world. This grim picture is common in developing countries where health services are inaccessible to a substantial portion of the population. The absence of medical staff during birth puts the mother and the child at high risk of developing complications and may lead to death. According to the United Nations Children's Emergency Fund (UNICEF), the following countries are ranked as having births least likely to be supervised by trained medical staff.
Only 16% of births in Ethiopia get the attention a trained medical staff and 676 out of 100,000 mothers died while giving birth in 2011. An estimated 83% of Ethiopia’s population lives in rural areas, and access to medical services are low because of inadequate health infrastructure. The facilities available are ill-equipped and lack amenities such as water and electricity to facilitate safe delivery. Ethiopia also has an insufficient number of delivery attendants who are expertly trained and skilled in dealing with birth complications.
Most women in Ethiopia give birth at home and are not aware of the advantages of seeking specialized medical care. Some of the women believe that delivery in a hospital is either not necessary or not customary. Distance from medical centers is also a hindrance to seeking medical care.
Trained medical staff supervises only 24% of births in Chad and has a low percentage of educated women at 37.2%. High levels of illiteracy among women contribute to most women giving birth in the absence of skilled medical staff. Lack of access to contraceptives among the women in Chad is the cause of high birth rates. Chad is a developing country and is characterized by inadequate and under-equipped health facilities. Poorly equipped staff are also unable to deal with a complication arising during the birth. As a result, Chad has one of the highest mortality rates in the world.
Niger has a high mortality rate and only 29% of births in the country getting attention of trained medical staff. Approximately 14,000 women in Niger die from complications during birth. The leading cause for women not accessing health care is tradition and culture, and delivery is commonly at home, particularly in the rural Chad. Inadequate and under-equipped facilities and under-trained medical staff make maternal healthcare system in Niger ill-equipped to handle complications. In some areas, non-governmental organizations have built health clinics. All these factors contribute to the high maternal death rate which was 820 for every 100,000 births in 2010.
In Haiti only 37% of all births were attended by a skilled medical staff and accessing health care for half of the population in Haiti is a big challenge. Poverty levels and inadequate health facilities are the primary causes for the inaccessibility of health services. In the Haiti has been hit by natural disasters most notably the earthquake in 2010 and displaced people and destroyed property including health facilities. Floods also destroyed infrastructure making it increasingly difficult for women to travel to health centers. Haiti also has few trained staff who can deal with complications and emergencies and as a result, mother mortality rate in the country was 35 per 1000 births in 2010.
Maternal and Infant Healthcare Infrastructure in the Third World
Other countries where births are least likely to be attended by skilled staff include Nigeria (38%), Afghanistan (39%), Guinea (39%), Mali (40%), Bangladesh (42%), Laos (42%), Tanzania (43%), Madagascar (44%), Guinea-Bissau (45%), Togo (45%) and Yemen (45%). Most of these countries are low-income countries where a large number of their population is economically disenfranchised and cannot afford medical services. Partnerships with governments from these countries and those from more developed countries have been established to accelerate improvements in maternal healthcare.