Long travel times from health center to hospital reduce caesarean section access : a study from Kirehe District, Rwanda
(2023) In Pan African Medical Journal 46.- Abstract
Introduction: timely access to safe cesarean section (c-section) delivery can save the lives of mothers and neonates. This paper explores how distance affects c-section access in rural sub-Saharan Africa, where women in labor present to health centers before being referred to district hospitals for surgical care. Methods: this study included all adult women delivering via c-section between April 2017 and March 2018 in Kirehe District, Rwanda. We assessed the association between travel times and village-level c-section rates. Results: the estimated travel time from home-to-health center was 26 minutes (IQR: 13, 41) and from health center-to-hospital was 43 minutes (IQR: 2, 59). There was no significant association between travel time... (More)
Introduction: timely access to safe cesarean section (c-section) delivery can save the lives of mothers and neonates. This paper explores how distance affects c-section access in rural sub-Saharan Africa, where women in labor present to health centers before being referred to district hospitals for surgical care. Methods: this study included all adult women delivering via c-section between April 2017 and March 2018 in Kirehe District, Rwanda. We assessed the association between travel times and village-level c-section rates. Results: the estimated travel time from home-to-health center was 26 minutes (IQR: 13, 41) and from health center-to-hospital was 43 minutes (IQR: 2, 59). There was no significant association between travel time from home-to-health center and c-section rates (RR=1.01, p=0.42), but the association was significant for health center-to-hospital travel times (RR=0.96, p=0.01); for every 15-minute increase in travel time, there was a 4% decrease in c-sections for a health center catchment area. Conclusion: in the context of decentralized health services, minimizing health center to hospital referral barriers is of utmost importance for improving c-section access in rural sub-Saharan Africa.
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- author
- Miller, Hillary ; Rudolfson, Niclas LU ; Nkurunziza, Theoneste ; Cherian, Teena ; Kayitesi, Daniella ; Mazimpaka, Christian ; Kateera, Fredrick ; Riviello, Robert and Hedt-Gauthier, Bethany
- organization
- publishing date
- 2023-09-01
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Africa, C-section, decentralization, global surgery
- in
- Pan African Medical Journal
- volume
- 46
- article number
- 30
- publisher
- African Field Epidemiology Network
- external identifiers
-
- pmid:38107338
- scopus:85177170175
- ISSN
- 1937-8688
- DOI
- 10.11604/pamj.2023.46.30.25504
- language
- English
- LU publication?
- yes
- id
- 7f3d41d2-821e-4472-ad0c-9024c87aa4be
- date added to LUP
- 2024-01-04 13:35:58
- date last changed
- 2024-04-19 09:51:27
@article{7f3d41d2-821e-4472-ad0c-9024c87aa4be,
abstract = {{<p>Introduction: timely access to safe cesarean section (c-section) delivery can save the lives of mothers and neonates. This paper explores how distance affects c-section access in rural sub-Saharan Africa, where women in labor present to health centers before being referred to district hospitals for surgical care. Methods: this study included all adult women delivering via c-section between April 2017 and March 2018 in Kirehe District, Rwanda. We assessed the association between travel times and village-level c-section rates. Results: the estimated travel time from home-to-health center was 26 minutes (IQR: 13, 41) and from health center-to-hospital was 43 minutes (IQR: 2, 59). There was no significant association between travel time from home-to-health center and c-section rates (RR=1.01, p=0.42), but the association was significant for health center-to-hospital travel times (RR=0.96, p=0.01); for every 15-minute increase in travel time, there was a 4% decrease in c-sections for a health center catchment area. Conclusion: in the context of decentralized health services, minimizing health center to hospital referral barriers is of utmost importance for improving c-section access in rural sub-Saharan Africa.</p>}},
author = {{Miller, Hillary and Rudolfson, Niclas and Nkurunziza, Theoneste and Cherian, Teena and Kayitesi, Daniella and Mazimpaka, Christian and Kateera, Fredrick and Riviello, Robert and Hedt-Gauthier, Bethany}},
issn = {{1937-8688}},
keywords = {{Africa; C-section; decentralization; global surgery}},
language = {{eng}},
month = {{09}},
publisher = {{African Field Epidemiology Network}},
series = {{Pan African Medical Journal}},
title = {{Long travel times from health center to hospital reduce caesarean section access : a study from Kirehe District, Rwanda}},
url = {{http://dx.doi.org/10.11604/pamj.2023.46.30.25504}},
doi = {{10.11604/pamj.2023.46.30.25504}},
volume = {{46}},
year = {{2023}},
}