Caesarean sections in Abraham Esau District Hospital

Abstract

BACKGROUND: Maternal and child health is one of the key focus areas of South African (SA) Department of Health in line with the Millennium Development Goals. Maternal and child health is therefore identified as a key performance area for healthcare facilities throughout the country. In SA, availability and/ or lack of services are often the difference between life and death. Caesarean section (CS) is regarded as one such intervention that can save both mother and baby’s lives. Outcome of CS as a life saving intervention are often based on certain factors (clinical and health systems) that predetermine it. It is important to identify these factors at institutional level to optimise better outcome. However, the practice of caesarean sections and the maternal and foetal outcome were not systematically and extensively studied at the hospital level. AIM: The aim of the study was to determine the frequency of CS in a district hospital in South Africa for an eighteen month period and to identify some factors which might influence that frequency and to describe the maternal and neonatal health outcomes. METHODOLOGY: Setting of this study was the maternity ward of the Abraham Esau District Hospital in Namaqua, Northern Cape Province. Study involved an eighteen month (1 January 2009 to 30 June 2010) retrospective review of hospital medical electronic database. No primary data was collected for this study. Variables used for the study include CS rates, the profile of women who had a CS, the health outcomes for the women and babies. RESULTS: The total number of deliveries during this period was four hundred and sixty two (462). Seventy-six of them were CS (16.4%). Approximately two thirds 50 (66%) of them were emergencies. The study found that emergency CSs were more commonly done among teenagers under the age of eighteen. Emergency CSs were also more commonly performed among patients who were transferred from surrounding clinics (20.8%). The majority of patients who had CS were single, unemployed and had no medical aid. CONCLUSION: The findings of this study will be useful to develop a better understanding of the frequency of CS at this Hospital and could be utilized by referring clinics and community health centres as well as other district hospitals for the improvement of health care service, particularly maternal and child health. The findings could serve as a base for informed decision-making, accurate planning, appropriate interventions, and optimal resources utilization. Further to this it could be a reference for future projects of similar nature for academic and clinical purposes.