title: Rate of caesarean section as a process indicator of safe-motherhood programmes: the case of Kenya.
abstract: The study assessed the value of currently-available data on the rates of caesarean section as an indicator of safe-motherhood programmes. Data, collected through the routine health information system of the Ministry of Health, Kenya, were used for analyzing the available process indicators. The methodology of this study illustrates both usefulness and limitations of readily-available healthcare information. The rate of hospital-based caesarean section was 6.3% of all births (range 0.3-37%), whereas the rate of population-based caesarean section was 0.95% (range 0.1%-4%). The rate of population-based caesarean section indicates a significant unmet need for obstetric care in the rural areas and may be a useful tool for monitoring progress on safe-motherhood initiatives in poor settings. Rates of population-based caesarean section are low in Kenya, especially in the rural areas. The rate of caesarean section may be a valuable process indicator for identifying the gaps in obstetric care and may be used for advocating improvements for healthcare to the relevant authorities.
authors.affiliation: Kenyatta National Hospital, Department of Obstetrics and Gynaecology, University of Nairobi.
authors.forename: P
authors.initials: P
authors.lastname: Gichangi
authors.forename: L
authors.initials: L
authors.lastname: Apers
authors.forename: M
authors.initials: M
authors.lastname: Temmerman
mesh_terms: D002585:Cesarean Section / Q000706:statistics & numerical data*; D003695:Delivery of Health Care; D005260:Female; D006801:Humans; D007630:Kenya; D008427:Maternal Health Services / Q000592:standards*; D018743:Perinatal Care / Q000592:standards*; D011203:Poverty; D011247:Pregnancy; D017064:Process Assessment, Health Care; D012189:Retrospective Studies; D019035:Rural Health Services / Q000592:standards*