Unnecessareans - use and misuse of cesarean section in low resource settings

Caesarean section (CS) is a lifesaving operation when done with good indication and should be available for all women of fertile age. A lot of effort is put into increasing access globally, in particular in low- and middle-income countries, where CS rates are below the recommended 5-10% threshold. Nevertheless, it is a dangerous operation in low resource settings for both mother and child, not least considering expected complications such as abnormal placentation, uterine scar rupture and consequently serious and possibly fatal haemorrhage in following pregnancies. CS should therefore only be used with proper medical indication. Increased access does not equal increased quality. In fact increased access may lead to many unnecessary CS, and an increase in maternal and perinatal mortality, therefore quality in setting criteria and timeliness, as well as quality in the operation is extremely important. Little research has been done on quality of obstetric services in low resource settings, but a few small studies have shown that as much as 50% of CS were without or with unclear medical indications in similar settings as in this study. Hence, while working to increase the Emergency Obstetric Care capacity in Sub-Sahara Africa, it is necessary that this at the same time is a question of quality, not only quantity. My ambition with the proposed research is to improve quality of maternal health services in order to provide safe, appropriate and timely obstetric care, and to reduce unwarranted caesarean sections. I wish to explore whether CS in a region of Tanzania were done with proper indication; what factors and barriers attribute to misuse of CS, long term consequences of caesarean sections in low resource settings, and health seeking behaviour in women previously having had a caesarean section, through both quantitative and qualitative studies.

Prosjektbeskrivelse med vedlegg

TSD

  • Ja

Biobank

  • Nei

Godkjenninger

REK - Ja 1 fil

Tidspunkt for anonymisering og sletting av dataene

  • Anonymisering: desember 2017
  • Sletting: juli 2018

Andre godkjenninger1 fil

Prosjektleder

Johanne Sundby

Ansvarlig enhet

Avdeling for samfunnsmedisin og global helse

Forskere

  • Marie Cecilie Paasche Roland
  • Jos van Roosmalen (Leiden University Netherlands)
  • Eusebius Maro
  • Sia Msuya
  • Vegard Weyergang Vartdal

Prosjekttype

  • Ph.d.-prosjekt

Helsefaglig forskning

  • Ja

Personopplysninger

  • Ikke besvart

Tidsperiode

  • Start: august 2017
  • Slutt: juni 2021
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