Cesarean sections for maternal indications in Kasongo (Zaire)

Authors:
  • WVW. VanLerberghe
    W. VanLerberghe
  • KPK. Pangu
    K. Pangu
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Abstract
Cesarean section rates in a rural area in Eastern Zaire are described. Indications are stringent and section is essentially performed on maternal indications. In the urban area cesarean section was performed for 1.1% of the expected births over a 9-year period, but only for 0.3% of expected births in the rural area, indicating a major problem in access to the district hospital. Section rates are compared with those reported for other settings.In developed countries, cesarean section incidences are well documented. In developing countries cesareans are not widely performed or documented. This study focuses on rural Kasongo in eastern Zaire and documents the incidence of cesarean sections in rural vs. urban areas. Kasongo has 1 typical rural African hospital and a network of health centers. An analysis of the literature yielded data on section rates in other than rural settings. These rates are subject to selection bias and unclear definition of "maternal indication." Rural vs. urban section rates in Kasongo from 1976-84 fluctuate greatly with the lowest rates always in the rural sector (0.3%-1.1% of expected births). These discrepancies may be due to untrained medical personnel, lack of supplies, lack of access to facilities, a high section mortality rate, or a combination of these factors.

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