Chart 5: Evolution of the maternal mortality rate from 1996 to 2015 Source: 1996-1997 DHS, 2004 DHS, 2009 GPHC and 2014-2015 DHS-MICS  Skilled attendance at birth 191. Ensuring skilled attendance at birth is essential in order to reduce maternal deaths. Thus, the percentage increase in births supervised by skilled health personnel is an indicator for measuring improvements in the maternal mortality rate, given that most maternal deaths are caused by haemorrhaging which can be prevented by the presence of skilled health personnel at birth. Skilled attendance at birth hence increased significantly from 15% in 1996-1997 to 34% in 2014-2015, i.e. an increase of 19 points. Chart 6: Rate of skilled birth attendance from 1996 to 2015 (%) Source: 1996-1997 DHS, 2004 DHS, 2010 MICS and 2014-2015 DHS-MICS surveys Page 47 sur 87