What do you mean by safe surgery?
Safe surgery means that the “staff , stuff , space, and systems” are in place to provide timely, safe, and affordable surgical care.1 Surgical care includes the continuum of care from admission to recovery, and incorporates evidence-based practices, surgical techniques, infection prevention practices, the WHO surgical safety checklist, and appropriate post-operative care.
Why does Jhpiego’s safe surgery program focus on C-sections?
At the district hospital level, where we primarily work, most major surgical procedures are C-sections, and most surgical teams manage all surgical cases. Therefore, strengthening surgical teams’ management of C-section carries over to other surgical care. While we focus on C-sections, we are continuously expanding safe surgery to include other maternal health procedures (e.g., ectopic, tubal ligation)
Isn’t there concern that C-section rates are rising?
There is concern over the global trend of increasing rates of C-sections, which was estimated at 21.1% in 2015, nearly double the rate in 2000, and represents overuse (“too much, too soon”). The World Health Organization has stated that C-sections are “effective in saving maternal and infant lives, but only when they are required for medically indicated reasons” and that C-section rates higher than 10% are not associated with reductions in maternal and newborn mortality rates.
However, in many parts of the world, lack of access or under use (“too little, too late”) is the prevailing situation. For example, in Ethiopia the national C-section rate is about 2%. Large variations in C-section use exist across countries and within countries, with both overuse and underuse often co-existing. This is seen in the large disparities between urban and rural populations, rich and poor, private and public institutions. It is essential, therefore, to understand the context, the drivers and barriers, to optimal C-sections use.