Skilled care at delivery is one of the key elements necessary to reduce maternal mortality. Though all regions show improvement, only 46 per cent of deliveries in sub-Saharan Africa, where almost half the world's maternal deaths occur, are assisted by skilled attendants.

In Southern Asia, the proportion is even lower. Eastern and South-Eastern Asia and Northern Africa have made the most headway, with increases in attended births of between 55 and almost 80 per cent.

In the vulnerable period of childbirth, poor and rural women are short-changed

Within countries, the presence of a skilled attendant at delivery is the most inequitably distributed among child and maternal health indicators.

Impoverished and rural women are far less likely than their urban or wealthier counterparts to receive skilled care during childbirth. Inequality between urban and rural care at delivery is particularly significant in sub-Saharan Africa: For 33 countries with data, urban women are over three times more likely to deliver with health personnel than women inrural areas. And women in the wealthiest fifth of the population are six times more likely to deliver with a health professional than those in the poorest fifth. Redressing these inequities will require continued analysis of trends matched by targeted policies.