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An Experimental Paradigm for the Prediction of Post-Operative Pain PPOP
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Caesarean sections and health financing: a global analysis.

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Health financing significantly impacts caesarean section (CS) rates globally. Increased private spending, particularly out-of-pocket and voluntary insurance, correlates with higher, potentially unnecessary, CS proportions.

Keywords:
health economicsobstetricspublic health

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Area of Science:

  • Global health
  • Health economics
  • Maternal health

Background:

  • Caesarean section (CS) rates vary significantly worldwide.
  • Understanding the drivers of CS utilization is crucial for optimizing maternal healthcare.
  • Health financing mechanisms may play a role in CS rates.

Purpose of the Study:

  • To investigate the association between health financing indicators and the proportion of caesarean sections (CS) across countries.
  • To analyze how different components of health financing relate to excess CS rates.

Main Methods:

  • Ecological cross-country study involving 172 countries.
  • Analysis of CS proportions, including excess proportions above global targets (19% and 9%).
  • Multivariable linear regressions to assess the impact of health financing factors (total health resources, private household contributions, national income) on excess CS proportions.

Main Results:

  • An estimated 8.8 million unnecessary CS occurred globally in 2018, predominantly in upper middle-income countries.
  • Private health financing showed a positive association with excess CS proportions.
  • A 10% increase in out-of-pocket expenditure was linked to a 0.7% rise in excess CS proportions.
  • A 10% increase in voluntary health insurance was associated with a 4% rise in excess CS proportions.

Conclusions:

  • Health system financing features are demonstrably associated with caesarean section utilization across nations.
  • Further monitoring of health financing indicators is essential to understand their impact on CS provision.
  • International and national-level analysis is needed to elucidate the role of financial arrangements in CS rates.