placestats

Physicians vs. Skilled birth attendance

Fades after adjusting for income

Across 174 countries, Physicians and Skilled birth attendance rise and fall together at r = +0.57 (on a scale from −1 to +1, where 0 means no link). Comparing only countries with similar income (GDP per person) shrinks it to +0.09, which could easily be chance (q = 0.10, allowing for the many pairs tested, and allowing for countries in the same region being alike). So the first figure mostly shows richer countries differing from poorer ones, not a link between these two things.

Comparing countries across the middle half of skilled birth attendance, 86% to 99.7% of births, physicians is better by 0.836 per 1,000 people at the top of that range than the bottom. Comparing only countries with similar national income, the gap is 0.11 per 1,000 people.

Link before adjusting (r)+0.571p = 2.1e-16 · 174 countries
After adjusting for national income+0.086p = 0.260 · likely range [-0.06, +0.23]
p, allowing for regions0.018standard error 0.027 · 7 regions
Check for luck (q)0.102across 12,497 pairs

How to read these.r runs from −1 (one goes up as the other goes down) to +1 (they rise together), and 0 means no link. Adjusting for national income means comparing countries with the same GDP per person, so differences in wealth can’t explain the link. Income is used in percentage terms, since an extra $1,000 means more to a poor country than to a rich one. p is how likely a link this strong would be if there were really none. Below 0.05 means it is unlikely to be chance. Very small values are written in short form: 1.1e-32 means a decimal point followed by 31 zeros and then 11, so very close to zero. The likely range is where the true figure probably lies, and a range that crosses zero means the link could easily be chance. Countries in the same region tend to resemble each other, so the third figure allows for that, which gives a fairer p. The standard error is the typical size of the error in r. Finally, testing this many pairs means some will look strong by luck alone. A q below 0.05 means this link is unlikely to be one of those.

Physicians · per 1,000 peoplelink with income +0.85 · proxy
Skilled birth attendance · % of birthslink with income +0.69 · high

Both of these rise and fall closely with national income, so a strong link between them before adjusting was close to certain. Read the adjusted figure, not the first one.

“Link with income” is how closely each measure tracks GDP per person across countries, from −1 to +1.

Every country as a dot

Physicians · per 1,000 people →Skilled birth attendance · % of births →0.0386.631.9%100%Afghanistan: 0.317 per 1,000 people, 61.8% of birthsAngola: 0.244 per 1,000 people, 49.6% of birthsAlbania: 1.88 per 1,000 people, 99.8% of birthsAndorra: 5.07 per 1,000 people, 100% of birthsUnited Arab Emirates: 2.99 per 1,000 people, 99.2% of birthsArgentina: 5.11 per 1,000 people, 98.8% of birthsArmenia: 3.36 per 1,000 people, 99.8% of birthsAntigua and Barbuda: 2.92 per 1,000 people, 99% of birthsAustralia: 4.09 per 1,000 people, 96% of birthsAustria: 5.51 per 1,000 people, 98.1% of birthsAzerbaijan: 3.19 per 1,000 people, 99.9% of birthsBurundi: 0.078 per 1,000 people, 76.5% of birthsBenin: 0.216 per 1,000 people, 78.1% of birthsBurkina Faso: 0.148 per 1,000 people, 79.8% of birthsBangladesh: 0.722 per 1,000 people, 59% of birthsBulgaria: 4.33 per 1,000 people, 94.5% of birthsBahrain: 0.741 per 1,000 people, 99.6% of birthsBahamas, The: 1.9 per 1,000 people, 99% of birthsBosnia and Herzegovina: 2.58 per 1,000 people, 99.9% of birthsBelarus: 4.72 per 1,000 people, 99.9% of birthsBelize: 1.09 per 1,000 people, 94.6% of birthsBolivia: 1.28 per 1,000 people, 81.1% of birthsBrazil: 2.36 per 1,000 people, 98.4% of birthsBarbados: 2.96 per 1,000 people, 98.4% of birthsBrunei Darussalam: 1.89 per 1,000 people, 99.6% of birthsBhutan: 0.553 per 1,000 people, 98.9% of birthsBotswana: 0.379 per 1,000 people, 99.8% of birthsCentral African Republic: 0.074 per 1,000 people, 40.3% of birthsCanada: 2.82 per 1,000 people, 98% of birthsChile: 3.33 per 1,000 people, 99.8% of birthsChina: 3.11 per 1,000 people, 99.9% of birthsCote d'Ivoire: 0.166 per 1,000 people, 84% of birthsCameroon: 0.136 per 1,000 people, 69% of birthsCongo, Dem. Rep.: 0.208 per 1,000 people, 85.2% of birthsCongo, Rep.: 0.173 per 1,000 people, 91.2% of birthsColombia: 2.54 per 1,000 people, 98.8% of birthsComoros: 0.424 per 1,000 people, 82.2% of birthsCabo Verde: 0.73 per 1,000 people, 97.3% of birthsCosta Rica: 2.69 per 1,000 people, 99% of birthsCyprus: 3.56 per 1,000 people, 99.3% of birthsCzechia: 4.35 per 1,000 people, 99.8% of birthsGermany: 4.53 per 1,000 people, 96.2% of birthsDjibouti: 0.211 per 1,000 people, 87.4% of birthsDominica: 1.16 per 1,000 people, 100% of birthsDenmark: 4.5 per 1,000 people, 95.3% of birthsDominican Republic: 2.43 per 1,000 people, 99.2% of birthsAlgeria: 1.66 per 1,000 people, 98.8% of birthsEcuador: 2.31 per 1,000 people, 99.4% of birthsEgypt, Arab Rep.: 0.671 per 1,000 people, 97.1% of birthsSpain: 4.29 per 1,000 people, 99.9% of birthsEstonia: 3.47 per 1,000 people, 99.6% of birthsEthiopia: 0.143 per 1,000 people, 49.8% of birthsFinland: 3.61 per 1,000 people, 99.5% of birthsFiji: 0.813 per 1,000 people, 99.8% of birthsFrance: 3.28 per 1,000 people, 98.2% of birthsGabon: 0.521 per 1,000 people, 89.3% of birthsGeorgia: 5.64 per 1,000 people, 99.8% of birthsGhana: 0.266 per 1,000 people, 78.9% of birthsGuinea: 0.21 per 1,000 people, 55.3% of birthsGambia, The: 0.09 per 1,000 people, 83.8% of birthsGuinea-Bissau: 0.252 per 1,000 people, 53.8% of birthsEquatorial Guinea: 0.153 per 1,000 people, 68.3% of birthsGreece: 6.58 per 1,000 people, 99.9% of birthsGrenada: 1.38 per 1,000 people, 100% of birthsGuatemala: 1.28 per 1,000 people, 69.6% of birthsGuyana: 1.39 per 1,000 people, 97.6% of birthsHonduras: 0.489 per 1,000 people, 94.1% of birthsCroatia: 3.91 per 1,000 people, 99.9% of birthsHaiti: 0.292 per 1,000 people, 41.6% of birthsHungary: 3.46 per 1,000 people, 99.7% of birthsIndonesia: 0.524 per 1,000 people, 94.7% of birthsIndia: 0.723 per 1,000 people, 89.4% of birthsIreland: 3.88 per 1,000 people, 99.7% of birthsIran, Islamic Rep.: 1.81 per 1,000 people, 99% of birthsIraq: 1.02 per 1,000 people, 95.6% of birthsIceland: 4.37 per 1,000 people, 97.4% of birthsItaly: 4.19 per 1,000 people, 99.8% of birthsJamaica: 0.46 per 1,000 people, 99.7% of birthsJordan: 2.85 per 1,000 people, 99.7% of birthsJapan: 2.65 per 1,000 people, 99.8% of birthsKazakhstan: 3.75 per 1,000 people, 99.9% of birthsKenya: 0.289 per 1,000 people, 70.2% of birthsKyrgyz Republic: 1.57 per 1,000 people, 100% of birthsCambodia: 0.211 per 1,000 people, 98.7% of birthsKiribati: 0.193 per 1,000 people, 91.9% of birthsSt. Kitts and Nevis: 3.08 per 1,000 people, 100% of birthsKorea, Rep.: 2.61 per 1,000 people, 100% of birthsKuwait: 2.27 per 1,000 people, 99.9% of birthsLao PDR: 0.331 per 1,000 people, 64.4% of birthsLiberia: 0.178 per 1,000 people, 84.4% of birthsLibya: 2.04 per 1,000 people, 99.9% of birthsSt. Lucia: 4.23 per 1,000 people, 100% of birthsSri Lanka: 1.14 per 1,000 people, 99.5% of birthsLesotho: 0.235 per 1,000 people, 86.6% of birthsLithuania: 4.47 per 1,000 people, 100% of birthsLatvia: 3.4 per 1,000 people, 99.9% of birthsMorocco: 0.74 per 1,000 people, 86.6% of birthsMoldova: 4.02 per 1,000 people, 99.6% of birthsMadagascar: 0.172 per 1,000 people, 45.8% of birthsMaldives: 2.23 per 1,000 people, 99.5% of birthsMexico: 2.59 per 1,000 people, 96.6% of birthsMarshall Islands: 0.467 per 1,000 people, 92.4% of birthsNorth Macedonia: 2.94 per 1,000 people, 100% of birthsMali: 0.188 per 1,000 people, 67.3% of birthsMalta: 4.51 per 1,000 people, 99.8% of birthsMyanmar: 0.757 per 1,000 people, 60.2% of birthsMontenegro: 2.78 per 1,000 people, 98.8% of birthsMongolia: 4.13 per 1,000 people, 99.3% of birthsMozambique: 0.175 per 1,000 people, 73% of birthsMauritania: 0.261 per 1,000 people, 70.4% of birthsMauritius: 1.44 per 1,000 people, 99.7% of birthsMalawi: 0.054 per 1,000 people, 96.4% of birthsMalaysia: 2.34 per 1,000 people, 99.6% of birthsNamibia: 0.553 per 1,000 people, 88.2% of birthsNiger: 0.038 per 1,000 people, 43.7% of birthsNigeria: 0.38 per 1,000 people, 50.7% of birthsNicaragua: 0.682 per 1,000 people, 94.1% of birthsNorway: 4.97 per 1,000 people, 99.2% of birthsNepal: 1.01 per 1,000 people, 77.2% of birthsNew Zealand: 3.61 per 1,000 people, 96.5% of birthsOman: 1.99 per 1,000 people, 99.9% of birthsPakistan: 1.16 per 1,000 people, 68% of birthsPanama: 1.63 per 1,000 people, 95% of birthsPeru: 1.69 per 1,000 people, 94.9% of birthsPhilippines: 0.792 per 1,000 people, 84.4% of birthsPalau: 1.81 per 1,000 people, 97.2% of birthsPapua New Guinea: 0.061 per 1,000 people, 56.4% of birthsPoland: 4.03 per 1,000 people, 99.6% of birthsPortugal: 5.85 per 1,000 people, 98.6% of birthsParaguay: 3.89 per 1,000 people, 92.2% of birthsWest Bank and Gaza: 2.17 per 1,000 people, 99.7% of birthsQatar: 3.02 per 1,000 people, 100% of birthsRomania: 3.63 per 1,000 people, 93% of birthsRussian Federation: 5.11 per 1,000 people, 99.6% of birthsRwanda: 0.09 per 1,000 people, 94.2% of birthsSaudi Arabia: 3.41 per 1,000 people, 94.8% of birthsSudan: 0.25 per 1,000 people, 77.7% of birthsSenegal: 0.109 per 1,000 people, 74.5% of birthsSingapore: 2.83 per 1,000 people, 99.6% of birthsSolomon Islands: 0.238 per 1,000 people, 86.2% of birthsSierra Leone: 0.134 per 1,000 people, 86.9% of birthsEl Salvador: 1.62 per 1,000 people, 99.9% of birthsSomalia, Fed. Rep.: 0.048 per 1,000 people, 31.9% of birthsSerbia: 3.1 per 1,000 people, 99.9% of birthsSao Tome and Principe: 0.464 per 1,000 people, 96.8% of birthsSuriname: 1.35 per 1,000 people, 98.4% of birthsSlovak Republic: 3.7 per 1,000 people, 98% of birthsSlovenia: 3.37 per 1,000 people, 99.8% of birthsEswatini: 0.557 per 1,000 people, 88.3% of birthsSeychelles: 6.6 per 1,000 people, 99.5% of birthsChad: 0.085 per 1,000 people, 47.2% of birthsTogo: 0.08 per 1,000 people, 69.4% of birthsThailand: 0.541 per 1,000 people, 99.1% of birthsTajikistan: 1.87 per 1,000 people, 94.8% of birthsTurkmenistan: 1.93 per 1,000 people, 100% of birthsTimor-Leste: 0.752 per 1,000 people, 56.7% of birthsTonga: 1.01 per 1,000 people, 98.3% of birthsTrinidad and Tobago: 4.16 per 1,000 people, 100% of birthsTunisia: 1.31 per 1,000 people, 99.5% of birthsTurkiye: 2.24 per 1,000 people, 97% of birthsTuvalu: 1.35 per 1,000 people, 99.5% of birthsTanzania: 0.134 per 1,000 people, 63.5% of birthsUganda: 0.191 per 1,000 people, 74.2% of birthsUkraine: 3.53 per 1,000 people, 99.9% of birthsUruguay: 4.67 per 1,000 people, 100% of birthsUnited States: 3.68 per 1,000 people, 99.1% of birthsUzbekistan: 2.81 per 1,000 people, 99% of birthsSt. Vincent and the Grenadines: 0.938 per 1,000 people, 98.6% of birthsViet Nam: 1.11 per 1,000 people, 96.1% of birthsVanuatu: 0.164 per 1,000 people, 89.4% of birthsSamoa: 0.561 per 1,000 people, 88.9% of birthsSouth Africa: 0.794 per 1,000 people, 96.7% of birthsZambia: 0.324 per 1,000 people, 80.4% of birthsZimbabwe: 0.136 per 1,000 people, 86% of birthsBWACAFGRCKHMMWINERPRTSOMSYC

best-fit line line after adjusting

Four ways to measure the link

MethodrpCountries
Standard (Pearson), not adjusted+0.5712.1e-16174
By rank (Spearman), not adjusted+0.7151.5e-28174
Standard (Pearson), adjusted for national income+0.0860.260174
By rank (Spearman), adjusted for national income+0.3318.8e-6174

The rank version uses only each country’s place in line, from lowest to highest, so a few extreme countries count for less. The adjusted and unadjusted versions use the same 174 countries: those that report both measures and GDP per person. So the gap between them comes from the adjustment, not from a change in which countries are counted. Drop in the size of r after adjusting: +0.484 (a minus sign means it grew).

How solid is it?

Leaving out one country at a time, r ranges from +0.069 (without AGO) to +0.103 (without SOM). The bar above shows that range on a scale from −1 to +1, with the solid line at the full result. The single country that moves r most: AGO (-0.017).

Within each region

Countries are not separate, unrelated cases, and neighbors share a lot. A link that holds inside each region is far more believable than one that shows up only when comparing regions.

nr
East Asia & Pacific27+0.08
Europe & Central Asia43+0.03
Latin America & Caribbean31+0.03
Middle East, North Africa, Afghanistan & Pakistan19+0.15
Sub-Saharan Africa46+0.10

By income third

If the link shows up only in the richest third of countries, it is a feature of rich countries, not a general pattern.

nr
Poorest third58+0.23
Middle third58+0.16
Richest third58+0.02

By largest religious group

Countries grouped by a label they share, such as main religion, rather than by a number. Groups of fewer than twelve countries are not shown. These groups differ in income, region and history all at once. So a gap between them is a place to start asking questions, not an answer.

nr
Christians102+0.09
Muslims47+0.33

By last european coloniser

Countries grouped by a label they share, such as main religion, rather than by a number. Groups of fewer than twelve countries are not shown. These groups differ in income, region and history all at once. So a gap between them is a place to start asking questions, not an answer.

nr
France23+0.04
Never a European colony21+0.28
Spain19+0.42
United Kingdom61+0.08

Without outliers (countries far outside the middle half of countries on either measure, by more than one and a half times the width of that middle half): r = +0.161 after dropping 18 countries.

Two series, one country

Both measures over the years for one country you pick. The two charts are stacked so they share only the years along the bottom.

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Over time, within countries

Everything above compares countries with each other at one moment. This section compares each country only with itself over 33years. So a link here can’t come from anything about a country that stays the same, such as its history, geography, institutions or culture.

The link shows up within countries over time (r = -0.130) but mostly disappears in year-to-year changes (r = +0.030). That points to slow trends particular to each country, not the two measures moving together from year to year.

Across countries (adjusted)+0.086for comparison
Within countries+0.096each country vs itself
…and vs the same year elsewhere-0.130q = 0.002 · 113 countries
Year-on-year changes+0.030q = 0.514

1,860 country-years (one country in one year), 113 countries, 1990–2022, about 17 years each on average. Share of the variation that happens within countries over time: 13% for Physicians, 13% for Skilled birth attendance. The margins of error allow for each country appearing many times, and for each year’s value being close to the year before.

Year-to-year changes are a cautious test, not a final answer. Looking only at changes from one year to the next removes each country’s own trends. But it also makes measurement mistakes louder, which pulls the results toward zero. A near-zero result here is weak evidence of no link, not proof.

With one measure years behind the other

0.20−0.2-100+10years Skilled birth attendance trails Physicians →lag -10: r = -0.095 (n = 1,381)lag -9: r = -0.107 (n = 1,472)lag -8: r = -0.117 (n = 1,524)lag -7: r = -0.127 (n = 1,567)lag -6: r = -0.118 (n = 1,634)lag -5: r = -0.130 (n = 1,725)lag -4: r = -0.143 (n = 1,809)lag -3: r = -0.154 (n = 1,802)lag -2: r = -0.145 (n = 1,870)lag -1: r = -0.131 (n = 1,862)lag +0: r = -0.130 (n = 1,860)lag +1: r = -0.129 (n = 1,792)lag +2: r = -0.134 (n = 1,749)lag +3: r = -0.126 (n = 1,683)lag +4: r = -0.128 (n = 1,606)lag +5: r = -0.134 (n = 1,541)lag +6: r = -0.115 (n = 1,483)lag +7: r = -0.134 (n = 1,451)lag +8: r = -0.116 (n = 1,375)lag +9: r = -0.113 (n = 1,291)lag +10: r = -0.113 (n = 1,252)

Same year (lag 0): -0.130. A peak away from zero does not show which comes first. These series change slowly — this year’s value is close to last year’s. That makes the curve smooth and nearly symmetric, whatever produced the data. Even a sharp peak at one lag (a gap of some years) would not prove that one measure changes the other.

The data


per 1,000 people
% of births		Years
Seychelles SYC6.699.5%2022, 2020
Greece GRC6.5899.9%2022, 2018
Portugal PRT5.8598.6%2022, 2020
Georgia GEO5.6499.8%2023, 2021
Austria AUT5.5198.1%2023, 2020
Russian Federation RUS5.1199.6%2022, 2020
Argentina ARG5.1198.8%2023, 2020
Andorra AND5.07100%2023, 2017
Norway NOR4.9799.2%2023, 2021
Belarus BLR4.7299.9%2023, 2020
Uruguay URY4.67100%2022, 2020
Germany DEU4.5396.2%2022, 2019
Malta MLT4.5199.8%2022, 2021
Denmark DNK4.595.3%2021, 2018
Lithuania LTU4.47100%2022, 2021

World Bank, World Development Indicators
World Bank, World Development Indicators

Sources

Physicians

Physicians (per 1,000 people)

World Health Organization · CC BY 4.0 · updated quarterly

Reported irregularly, so the latest value in the time window used is from a different year for different countries. Hospital beds, already on the site, have no "better" direction, since more beds is not plainly better. More doctors is closer to plainly better, so a direction is set on that basis.

Skilled birth attendance

Births attended by skilled health staff (% of total)

UNICEF and WHO · CC BY 4.0 · updated quarterly

Based on surveys, so a country reports it every few years rather than yearly.

How this was computed

Data used: most recent value in 2010-2025; values come from 2011–2023. To adjust for income, each measure is first predicted from GDP per person (in percentage terms, on a log scale) with a straight-line fit. Only what is left over is then compared. This is called a partial correlation. The line is drawn the standard way (ordinary least squares), which picks the line that comes closest to all the countries at once. The error margins allow for countries in the same region resembling each other, using 7 World Bank regions. The q-value corrects for testing all 12,497 pairs at once, using the Benjamini–Hochberg method. Underlying data last updated DYB 2024. How the country data works · explore Physicians and Skilled birth attendance

This page shows that two measures go together. It does not show that Physicians changes Skilled birth attendance, or the reverse. These figures also describe countries, not individual people. See the ecological fallacy.

More links with Physicians or Skilled birth attendance