↓ Skip to main content

Caesarean section audit to improve quality of care in a rural referral hospital in Tanzania

Overview of attention for article published in BMC Pregnancy and Childbirth, May 2018
Altmetric Badge

About this Attention Score

  • In the top 25% of all research outputs scored by Altmetric
  • Good Attention Score compared to outputs of the same age (70th percentile)

Mentioned by

blogs
1 blog

Citations

dimensions_citation
3 Dimensions

Readers on

mendeley
38 Mendeley
You are seeing a free-to-access but limited selection of the activity Altmetric has collected about this research output. Click here to find out more.
Title
Caesarean section audit to improve quality of care in a rural referral hospital in Tanzania
Published in
BMC Pregnancy and Childbirth, May 2018
DOI 10.1186/s12884-018-1814-1
Pubmed ID
Authors

Luuk Dekker, Tessa Houtzager, Omary Kilume, John Horogo, Jos van Roosmalen, Angelo Sadock Nyamtema

Abstract

Caesarean section (CS) is often a life-saving procedure, but can also lead to serious complications, even more so in low-resource settings. Therefore unnecessary CS should be avoided and optimal circumstances for vaginal delivery should be created. In this study, we aim to audit indications for Caesarean sections and improve decision-making and obstetric management. Audit of all cases of CS performed from January to August 2013 was performed in a rural referral hospital in Tanzania. The study period was divided in three audit blocks; retrospective (before auditing), prospective 1 and prospective 2. A local audit panel (LP) and an external auditor (EA) judged if obstetric management was adequate and indications were appropriate or if CS could have been prevented and yet retain good pregnancy outcome. Furthermore, changes in modes of deliveries, overall pregnancy outcome and decision-to-delivery interval were monitored. During the study period there were 1868 deliveries. Of these, 403 (21.6%) were Caesarean sections. The proportions of unjustified CS prior to introduction of audit were as high as 34 and 75%, according to the respective judgments of LP and EA. Following introduction of audit, the proportions of unjustified CS decreased to 23% (p = 0.29) and 52% (p = 0.01) according to LP and EA respectively. However, CS rate did not change (20.2 to 21.7%), assisted vacuum delivery rate did not increase (3.9 to 1.8%) and median decision-to-delivery interval was 83 min (range 10 - 390 min). Although this is a single center study, these findings suggest that unnecessary Caesarean sections exist at an alarming rate even in referral hospitals and suggest that a vast number can be averted by introducing a focused CS audit system. Our findings indicate that CS audit is a useful tool and, if well implemented, can enhance rational use of resources, improve decision-making and harmonise practice among care providers.

Mendeley readers

The data shown below were compiled from readership statistics for 38 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 38 100%

Demographic breakdown

Readers by professional status Count As %
Student > Bachelor 8 21%
Student > Master 8 21%
Student > Ph. D. Student 6 16%
Student > Postgraduate 6 16%
Professor 1 3%
Other 6 16%
Unknown 3 8%
Readers by discipline Count As %
Medicine and Dentistry 13 34%
Nursing and Health Professions 6 16%
Social Sciences 6 16%
Business, Management and Accounting 2 5%
Agricultural and Biological Sciences 1 3%
Other 2 5%
Unknown 8 21%

Attention Score in Context

This research output has an Altmetric Attention Score of 6. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 15 May 2018.
All research outputs
#2,980,879
of 12,942,974 outputs
Outputs from BMC Pregnancy and Childbirth
#819
of 2,369 outputs
Outputs of similar age
#79,478
of 270,939 outputs
Outputs of similar age from BMC Pregnancy and Childbirth
#1
of 1 outputs
Altmetric has tracked 12,942,974 research outputs across all sources so far. Compared to these this one has done well and is in the 76th percentile: it's in the top 25% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 2,369 research outputs from this source. They typically receive more attention than average, with a mean Attention Score of 7.9. This one has gotten more attention than average, scoring higher than 60% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 270,939 tracked outputs that were published within six weeks on either side of this one in any source. This one has gotten more attention than average, scoring higher than 70% of its contemporaries.
We're also able to compare this research output to 1 others from the same source and published within six weeks on either side of this one. This one has scored higher than all of them