How does hospital organisation influence the use of caesarean sections in low- and middle-income countries? A cross-sectional survey in Argentina, Burkina Faso, Thailand and Vietnam for the QUALI-DEC project - Centre Population et Développement (UMR 196) Access content directly
Journal Articles BMC Pregnancy and Childbirth Year : 2024

How does hospital organisation influence the use of caesarean sections in low- and middle-income countries? A cross-sectional survey in Argentina, Burkina Faso, Thailand and Vietnam for the QUALI-DEC project

Ana Pilar Betrán
  • Function : Author
Michael Robson
  • Function : Author
Charles Kaboré
  • Function : Author
Pisake Lumbiganon
  • Function : Author
Guillermo Carroli
  • Function : Author
Quoc Nhu Hung Mac
  • Function : Author
Celina Gialdini
  • Function : Author
Newton Opiyo
  • Function : Author
Meghan Bohren
  • Function : Author
Charles Kaboré
  • Function : Author
Fadima Yaya Bocoum
  • Function : Author
Simon Tiendrébéogo
  • Function : Author
Roger Zerbo
  • Function : Author
Dittakarn Boriboonhirunsarn
  • Function : Author
Nampet Jampathong
  • Function : Author
Kiattisak Kongwattanakul
  • Function : Author
Ameporn Ratinthorn
  • Function : Author
Olarik Musigavong
  • Function : Author
Liana Campodonico
  • Function : Author
Berenise Carroli
  • Function : Author
Gabriela Garcia Camacho
  • Function : Author
Daniel Giordano
  • Function : Author
Hugo Gamerro
  • Function : Author
Quoc Nhu Hung Mac
  • Function : Author
Thao Truong
  • Function : Author
Tran Minh Thien Ngo
  • Function : Author
Bui Duc Toan
  • Function : Author
Huynh Nguyen Khanh Trang
  • Function : Author
Hoang Thi Diem Tuyet
  • Function : Author
Claudia Hanson
  • Function : Author
Helle Molsted-Alvesson
  • Function : Author
Kristi Sidney Annerstedt
  • Function : Author
Mariana Romero
  • Function : Author
Ramon Escuriet
  • Function : Author
Olga Canet
  • Function : Author
Karen Zamboni
  • Function : Author
Laurence Lombard
  • Function : Author

Abstract

Abstract Background Improving the understanding of non-clinical factors that lead to the increasing caesarean section (CS) rates in many low- and middle-income countries is currently necessary to meet the challenge of implementing effective interventions in hospitals to reverse the trend. The objective of this study was to study the influence of organizational factors on the CS use in Argentina, Vietnam, Thailand and Burkina Faso. Methods A cross-sectional hospital-based postpartum survey was conducted in 32 hospitals (8 per country). We selected women with no potential medical need for CS among a random sample of women who delivered at each of the participating facilities during the data collection period. We used multilevel multivariable logistic regression to analyse the association between CS use and organizational factors, adjusted on women’s characteristics. Results A total of 2,092 low-risk women who had given birth in the participating hospitals were included. The overall CS rate was 24.1%, including 4.9% of pre-labour CS and 19.3% of intra-partum CS. Pre-labour CS was significantly associated with a 24-hour anaesthetist dedicated to the delivery ward (ORa = 3.70 [1.41; 9.72]) and with the possibility to have an individual room during labour and delivery (ORa = 0.28 [0.09; 0.87]). Intra-partum CS was significantly associated with a higher bed occupancy level (ORa = 1.45 [1.09; 1.93]): intrapartum CS rate would increase of 6.3% points if the average number of births per delivery bed per day increased by 10%. Conclusion Our results suggest that organisational norms and convenience associated with inadequate use of favourable resources, as well as the lack of privacy favouring women’s preference for CS, and the excessive workload of healthcare providers drive the CS overuse in these hospitals. It is also crucial to enhance human and physical resources in delivery rooms and the organisation of intrapartum care to improve the birth experience and the working environment for those providing care. Trial registration The QUALI-DEC trial is registered on the Current Controlled Trials website ( https://www.isrctn.com/ ) under the number ISRCTN67214403.
Fichier principal
Vignette du fichier
Publication_How does hospital organisation influence the use of caesarean sections in low- and middle-income countries_QUALI-DEC project.pdf (1.57 Mo) Télécharger le fichier
Origin : Publisher files allowed on an open archive

Dates and versions

hal-04403281 , version 1 (18-01-2024)

Identifiers

Cite

Camille Etcheverry, Ana Pilar Betrán, Myriam de Loenzien, Michael Robson, Charles Kaboré, et al.. How does hospital organisation influence the use of caesarean sections in low- and middle-income countries? A cross-sectional survey in Argentina, Burkina Faso, Thailand and Vietnam for the QUALI-DEC project. BMC Pregnancy and Childbirth, 2024, 24 (1), pp.67. ⟨10.1186/s12884-024-06257-w⟩. ⟨hal-04403281⟩
33 View
9 Download

Altmetric

Share

Gmail Facebook X LinkedIn More