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Socioeconomic differentials in caesarean rates in developing countries: a retrospective analysis
Carine Ronsmans1, Sara Holtz, Cynthia Stanton
1Infectious Disease Epidemiology Unit, London School of Hygiene and Tropical Medicine, London, UK. carine.ronsmans@lshtm.ac.uk
Lancet (London, England)
|October 31, 2006
Summary
Access to life-saving caesarean surgery varies significantly by socioeconomic status in developing nations. Many poor populations have minimal access, while some wealthier nations exceed medical need, highlighting urgent policy concerns.
Area of Science:
- Obstetrics and Gynecology
- Global Health Equity
- Health Services Research
Background:
- Access to caesarean delivery is critical for reducing maternal mortality.
- Socioeconomic disparities in accessing essential obstetric surgery are poorly understood.
- This study investigates caesarean birth rates across different socioeconomic strata in developing countries.
Purpose of the Study:
- To examine socioeconomic differences in population-based caesarean rates.
- To identify disparities in access to life-saving obstetric surgery.
- To inform policy on maternal health interventions.
Main Methods:
- Utilized data from 42 Demographic and Health Surveys across Africa, Asia, and Latin America.
- Analyzed caesarean rates stratified by wealth quintiles.
- Compared rates between the richest and poorest populations, including rural subgroups.
Main Results:
- Caesarean rates were below 1% for the poorest 20% in 20 countries.
- In six countries, less than 1% of the population had access to caesareans.
- Seven countries, primarily in Latin America, exceeded the 15% threshold for at least 40% of the population.
Conclusions:
- Significant disparities exist, with minimal access for the poorest in sub-Saharan Africa.
- Some middle-income countries demonstrate rates exceeding medical necessity.
- Urgent policy attention is required at national and international levels to address these inequities.
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