The impact of community midwives on maternal healthcare utilization

Globally 800 women die every day from preventable causes related to pregnancy and childbirth. One of the major reasons for high maternal mortality ratios in many developing countries is the low proportion of births attended by Skilled Birth Attendants (SBA). To address the high number of maternal deaths, in 2008 the Government of Pakistan introduced the Community Midwives Program. Under the program, women from across the country were trained and deployed as Community Midwives. In this study, I use six rounds of Pakistan Social and Living Measurement Survey to estimate the impact of this program on maternal healthcare utilization. I find that women residing in districts with higher Community Midwives per capita were 9 percentage points more likely to be attended by a SBA at the time of delivery and were 8 percentage points more likely to give birth at a medical facility as opposed to birthing at home. I find no evidence of impact on take up of prenatal and post-natal check-ups. The use of Community Midwives may be a cost effective tool to reduce maternal deaths, especially for developing countries with low health budgets.