Abstract:

Background: The World Health Organization considers Cesarean section rates of 5-15% to be the optimal range for targeted provision of this life saving intervention. Despite cesarean section having a number of negative financial impacts as well as a risk of fatal maternal and fetal outcomes its rate is progressively increasing with time, however there are no new indications for this procedure. There are studies which found that the use of health insurances in some areas has facilitated the increase in the rates of caesarean section. In the light of the rising trend in global cesarean section rates, there seems to be a need to find out the extent of the situation in a lower sector of the health system in Tanzania at the level of the district.

Objectives: To determine the prevalence of caesarean section, its indications and the role of health insurances at a district hospital in Tanzania.

Methodology: This was a retrospective cross sectional study done at Kahama District hospital targeting all pregnant women who delivered at the hospital from November 2014 to February 2015. A special collection form was used to obtain data from the delivery book in the ward as well as the operation record book from the obstetric theatre.

Results: In this study, the prevalence of CS was found to be 7.2% from which 76.3% were emergency CS and the rest were relative CS. The majority of women who underwent the CS were with age groups 15-19 (22.2%) and 20-24 years (23.7%). The leading indications for the CS done were CPD (18.8%) and prolonged labour (18.8%). Furthermore, only 21.7% of the CS were covered by health insurances.

Conclusion: The prevalence of caesarean section was within ideal rate according to WHO. Majority of CS were emergencies, involving women in their late teens and twenties and most of them were primigravida. The CS were done under appropriate indications in which CPD and prolonged labour were more common. The CS done were not Influenced by use of health insurance.