Assessment of cesarean delivery availability in 26 low- and middle-income countries: a cross-sectional study
Ologunde, R.; Vogel, J.P.; Cherian, M.N.; Sbaiti, M.; Merialdi, M.; Yeats, J.
American Journal of Obstetrics and Gynecology 211(5): 504.E1-504.E12
2014
ISSN/ISBN: 0002-9378 PMID: 24844851 DOI: 10.1016/j.ajog.2014.05.022Document Number: 626007
We sought to assess the capacity to provide cesarean delivery (CD) in health facilities in low- and middle-income countries. 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. 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. 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.
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