background information

The SAFE study has seven components;

• Situation analysis tool development - This will guide policy makers and programme managers to develop a framework to assess existing situations in their countries related to skilled attendance.
  
  
• Needs assessment for the poorest women - This will generate new knowledge on delivery care requirements among the poorest women.
  
  
• Interpretative guidelines - Guidelines for interpreting trends in proportions of deliveries with skilled attendance will be developed using Demographic Health Survey data.
  
  
• Monitoring skilled attendance - Rapid assessment methods for using primary data to track the proportion of deliveries with skilled attendance will be developed.
  
  
• Tool application - Development of the components listed above will make up a composite strategy development tool to increase the proportion of skilled attendance in developing countries that will be applied and tested in four countries.
  
  
• Proposals for demonstration projects - This will results from application of the tool. Although application of the tool will result in the formation of proposals for interventions to increase the proportion of deliveries with skilled attendance, the study will not extend to actually implementing the interventions proposed.
  
  
• Awareness - Dissemination of experiences and the research findings is an essential component that will lead to the wider application of the SAFE strategy development tool.

The proposed programme of operational research will be conducted by an international collaborative network providing the essential inter-agency, multi-disciplinary and multi-professional inputs required to meet the stated aims and objectives. The network - called the SAFE (Skilled Attendance For All) partnership - will be co-ordinated and facilitated by the Dugald Baird Centre for Research on Women's Health, University of Aberdeen. Together the partners represent a unique association of reproductive health researchers, programme managers, policy makers, health professionals, advocacy groups and international organisations. The five collaborating countries are Bangladesh, Ghana, Jamaica, Malawi, and Mexico, representing the continuum of settings in terms of both current proportions of deliveries with skilled attendance (from 14% to 92%) and levels of resources.

1 March 2000

University Receives Major International Award of Over
£½ Million from the European Commission

By the time you have read the following text, at least one woman will have died during pregnancy or childbirth in a developing country

This is the stark reality faced today by the poor majority of the world's women as they endure the risks of maternal mortality that were encountered in Scotland almost a century ago.

Since its launch in May 1995, the University's Dugald Baird Centre has undertaken research that seeks to reduce the number of these avoidable deaths in the poorer parts of the world. The Centre has now received the largest grant for international health research of its kind in the 500 year history of the University - over half a million pounds.

Dr Wendy Graham, Director of the Dugald Baird Centre, explained: "The award from the European Commission is for a 30-month project which we - the investigators - have called SAFE - Skilled Attendance For Everyone. Whereas virtually all deliveries in the western world occur in the presence of a health professional - a midwife, nurse or doctor, in poorer countries the majority have no such assistance".

"In Bangladesh for example, less than 10% of women delivering babies have a skilled attendant to ensure a clean, safe delivery and to deal appropriately with any complications which may arise - complications which can be life-threatening. In the United Kingdom by contrast, the figure is very nearly 100% - since some babies do arrive at unexpected times! It is now acknowledged that enabling women in developing countries to have professional delivery care is the single most important way to prevent maternal deaths. The EC-funded project aims to make this a reality".

"By identifying with our collaborators the factors which prevent women having high quality delivery care, be these for example problems of money, distance to facilities or an absolute lack of midwives, we hope to facilitate the process of finding practical solutions - solutions which are acceptable to women and appropriate to the resource constraints of the country".

Working with partners in six countries - Bangladesh, Ghana, Jamaica, Malawi, Mexico and Yemen, the Aberdeen-based investigators will be developing strategies to increase the proportion of women delivering with skilled personnel. Led by Professor Graham, a world-expert on maternal mortality, the Aberdeen team (Dr Julia Hussein, Dr Colin Bullough, Prof Marion Hall, Ms Jacqueline Bell, Dr Alice Kiger, Ms Vanora Hundley and Dr Edwin van Teijlingen) is multi-disciplinary and multi-professional, drawing together expertise not only from the Department of Obstetrics and Gynaecology and of Public Health but also the University's Centre for Advanced Studies in Nursing.

The research project is very much in the tradition of Sir Dugald Baird - the famous professor of midwifery who practised in Aberdeen from 1937 to 1965 and who fought tirelessly to improve the health of mothers and their babies, and after whom the University's Dugald Baird Centre is named.

This international project also has key collaborative partners in London, the United States and at the World Health Organization in Geneva.