[EQ] Socioeconomic differentials in caesarean rates in developing countries

Socioeconomic differentials in caesarean rates in developing countries:
a retrospective analysis

Carine Ronsmans, Sara Holtz and Cynthia Stanton

The Lancet, Volume 368, Number 9546, 28 October 2006

Available online at:
http://www.thelancet.com/journals/lancet/article/PIIS0140673606696396/fullte
xt

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".Socioeconomic inequalities in use of maternal health services have gained
increased attention in recent years.1,2 Disparities between poor and rich in
access to a skilled attendant at delivery are substantial in the developing
world.1,3 Differences in uptake of maternal-health care are often greater
within than between countries and are generally greater than those shown for
uptake of child-health services.4 In many countries, nearly 100% of the very
rich have access to a skilled attendant compared with almost none of the
very poor.3

Little is known about socioeconomic differentials in access to life-saving
obstetric care in hospitals, yet women's timely access to competent hospital
care is essential to achieve low levels of maternal mortality.5,6 The main
reason for this gap is that defining timely and competent life-saving care
is not easy. De Brouwere and Van Lerberghe7 developed a powerful indicator
of access to life-saving obstetric surgery, but the reliance on
health-facility records makes the ascertainment of socioeconomic status
difficult. Population-based caesarean rates have been promoted as indicators
of access to life-saving obstetric care,8 although the optimum rate is still
a matter of debate . "

 This work was undertaken as part of an international research programme,
the Initiative for Maternal Mortality Programme Assessment (IMMPACT),
which is funded by the Bill & Melinda Gates Foundation, the Department for
International Development, the European Commission, and USAID

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Received on Mon Oct 30 12:19:20 2006