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Am J Obstet Gynecol. 2014 Nov;211(5):504.e1-504.e12. doi: 10.1016/j.ajog.2014.05.022. Epub 2014 May 17.

Assessment of cesarean delivery availability in 26 low- and middle-income countries: a cross-sectional study.

Author information

1
Faculty of Medicine, School of Public Health, Imperial College London, St Mary's Hospital, London, United Kingdom; Emergency and Essential Surgical Care Program, Health Systems and Innovation. Electronic address: Rele.ologunde09@imperial.ac.uk.
2
Department of Reproductive Health and Research, United Nations Development Programme/United Nations Fund for Population Activities/United Nations International Children's Emergency Fund/World Health Organization (WHO)/World Bank Special Programme of Research, Development, and Research Training in Human Reproduction; Faculty of Medicine, Dentistry and Health Sciences, School of Population Health, University of Western Australia, Crawley, Australia.
3
Emergency and Essential Surgical Care Program, Health Systems and Innovation.
4
Faculty of Medicine, School of Public Health, Imperial College London, St Mary's Hospital, London, United Kingdom.
5
Department of Reproductive Health and Research, United Nations Development Programme/United Nations Fund for Population Activities/United Nations International Children's Emergency Fund/World Health Organization (WHO)/World Bank Special Programme of Research, Development, and Research Training in Human Reproduction.

Abstract

OBJECTIVE:

We sought to assess the capacity to provide cesarean delivery (CD) in health facilities in low- and middle-income countries.

STUDY DESIGN:

We conducted secondary analysis of 719 health facilities, in 26 countries in Africa, the Pacific, Asia, and the Mediterranean, using facility-based cross-sectional data from the World Health Organization Situational Analysis Tool to Assess Emergency and Essential Surgical Care.

RESULTS:

A total of 531 (73.8%) facilities reported performing CD. In all, 126 (17.5%) facilities did not perform but referred CD; the most common reasons for doing so were lack of skills (53.2%) and nonfunctioning equipment (42.9%). All health facilities surveyed had at least 1 operating room. Of the facilities performing CD, 47.3% did not report the presence of any type of anesthesia provider and 17.9% did not report the presence of any type of obstetric/gynecological or surgical care provider. In facilities reporting a lack of functioning equipment, 26.4% had no access to an oxygen supply, 60.8% had no access to an anesthesia machine, and 65.9% had no access to a blood bank.

CONCLUSION:

Provision of CD in facilities in low- and middle-income countries is hindered by a lack of an adequate anesthetic and surgical workforce and availability of oxygen, anesthesia, and blood banks.

KEYWORDS:

cesarean delivery; low- and middle-income countries; obstetric services; surgery

PMID:
24844851
DOI:
10.1016/j.ajog.2014.05.022
[Indexed for MEDLINE]

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