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Estimating c-section coverage: Assessing method performance and characterizing variations in coverage.

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This summary is machine-generated.

Cesarean sections (c-sections) are vital for preventing maternal and newborn deaths. However, access to medically necessary c-sections remains inequitable in low- and middle-income countries, highlighting disparities by wealth.

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Area of Science:

  • Global Health
  • Obstetrics & Gynecology
  • Health Equity

Background:

  • Cesarean section (c-section) is critical for preventing stillbirths and maternal/newborn mortality.
  • Data on medically necessary c-section coverage is scarce in low- and middle-income countries (LMICs).

Purpose of the Study:

  • To estimate national c-section coverage in 98 LMICs.
  • To analyze c-section access disparities based on household wealth.
  • To assess the impact of different definitions on country classifications for c-section access.

Main Methods:

  • Utilized household survey data from 98 LMICs.
  • Estimated medically necessary c-section coverage by stratifying by wealth quintiles.
  • Assumed 12.5% of births necessitate c-section, capping coverage at 100% per stratum.
  • Examined variations by wealth, national income, and obstetric transition stage.

Main Results:

  • Increasing national and household wealth correlates with higher c-section coverage and rates.
  • Significant wealth-based inequities in c-section coverage exist within countries.
  • Coverage gaps in poorer subpopulations persist even in countries with high national c-section rates.
  • Classification of adequate c-section access varies based on chosen indicators and thresholds.

Conclusions:

  • Stratifying c-section coverage by wealth is crucial for accurately identifying access gaps.
  • National c-section rates alone can obscure critical subnational inequities.
  • Accurate measurement of c-section access is increasingly important in LMICs due to rising inequities.