What is it about?
This article provides results of introducing caesarean deliveries and anaesthesia, and how these objectives were achieved in under-served rural Tanzania. Based on the results the authors conclude that increasing availability and quality of CS by improving infrastructure, training and audit of reasons for CS is feasible, acceptable and required in low resource settings.
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Why is it important?
Caesarean section (CS) is one of the key interventions that are used to treat direct obstetric complications that cause the vast majority of maternal and perinatal deaths around the globe. On the contrary, CS is still hugely inaccessible in most underserved rural areas in sub-Saharan Africa. In rural Tanzania, where 69% of the population lives, the caesarean section rate is only 3.2% (below 5% the minimum recommended by WHO) compared to 9.6% in urban areas. Such poor access to CS services indicates that a significant number of women and newborns are losing their lives, and others develop severe morbidity because of the absence of these services.
Perspectives
This article strongly suggests that upgrading health centres to provide caesarean section services in underserved rural areas using locally available associate clinicians has been shown to increase facility delivery rates, reduce phase two delays and referral costs and improve pregnancy outcomes. The fact that this project used existing resources, project interventions are more likely to be sustainable and replicable. I recommend that Ministries of Health in other resource limited countries strongly consider using the findings and experiences presented in this article to design and implement similar projects to improve maternal and perinatal health in their rural settings.
Dr Angelo S Nyamtema
Tanzanian Training Centre for International Health
Read the Original
This page is a summary of: Increasing the availability and quality of caesarean section in Tanzania, BJOG An International Journal of Obstetrics & Gynaecology, July 2016, Wiley,
DOI: 10.1111/1471-0528.14223.
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