Caesarean section audit to improve quality of care in a rural referral hospital in Tanzania

BMC Pregnancy and Childbirth
Luuk DekkerA Nyamtema

Abstract

Caesarean section (CS) is often a life-saving procedure, but can also lead to serious complications, even more so in low-resource settings. Therefore unnecessary CS should be avoided and optimal circumstances for vaginal delivery should be created. In this study, we aim to audit indications for Caesarean sections and improve decision-making and obstetric management. Audit of all cases of CS performed from January to August 2013 was performed in a rural referral hospital in Tanzania. The study period was divided in three audit blocks; retrospective (before auditing), prospective 1 and prospective 2. A local audit panel (LP) and an external auditor (EA) judged if obstetric management was adequate and indications were appropriate or if CS could have been prevented and yet retain good pregnancy outcome. Furthermore, changes in modes of deliveries, overall pregnancy outcome and decision-to-delivery interval were monitored. During the study period there were 1868 deliveries. Of these, 403 (21.6%) were Caesarean sections. The proportions of unjustified CS prior to introduction of audit were as high as 34 and 75%, according to the respective judgments of LP and EA. Following introduction of audit, the proportions of unjustified CS decr...Continue Reading

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Citations

Dec 18, 2019·BJOG : an International Journal of Obstetrics and Gynaecology·C J NgongoM Temmerman
May 24, 2021·BMC Pregnancy and Childbirth·Wouter BakkerThomas van den Akker
Aug 28, 2021·International Journal of Environmental Research and Public Health·Lahai TuckerChiyembekezo Kachimanga

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Methods Mentioned

BETA
Caesarean section

Software Mentioned

SPSS

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