Browsing by Author "Mureko, Charles"

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    Rates, indications and outcomes of Caesarean sections at Queen Elizabeth Central Hospital
    (Kamuzu University of Health Sciences, 2020-11-09) Matola, Yankho Matola; Mkomba, Susan; Mureko, Charles
    Type of study: A retrospective study of caesarean sections at Queen Elizabeth Central Hospital in Blantyre, Malawi. Problem: The World Health Organization (WHO) has over the years recommended that the rate of Caesarean sections (CS) at a population should be between 5-15% [1]. But of late, governments and clinicians have expressed concern over the increase in the rate of CS. Population in this context means the number of patients (pregnant women) served by a health facility [1]. The global rates of CS as of 2014 stood at 19.01%[11], this is higher for other countries and lower for others and also generally higher for private healthcare facilities than government run facilities [10]. In Malawi, the rates of CS stand at a countrywide rate of 6% [8]. In Malawi knowledge on healthcare facility specific rates of CS is limited. It is the aim of this study therefore to review the rates, common indications and outcomes of CS at Queen Elizabeth Central Hospital (QECH) which is a tertiary level healthcare facility in Malawi. Rates of CS below 5% are considered as the service (CS) is being denied to the population while rates above 15% are considered as there being a burden (pressure) on the healthcare facility serving a particular population [1]. If CS rates are within the recommended ideal rate by WHO, there is evidence that they can help to reduce maternal and perinatal morbidity and mortality in as far as the resources required for a CS are available [1]. This study therefore will help to provide up to date information on the rates, common indications and outcomes of Caesarean sections at QECH. Objectives. Broad: To review caesarean section deliveries at Queen Elizabeth Central Hospital (QECH). Specific: To determine the rate of caesarean sections at QECH; To evaluate common indications for caesarean sections at QECH; To assess the common outcomes (positive and negative) associated with caesarean sections at QECH. Methodology. Study design. Study location: Queen Elizabeth Central Hospital, Obstetrics and Gynaecology department. Study population. Women who delivered at Queen Elizabeth Central Hospital for the period from 1st January 2019 to 31st December 2019. Sample size and sampling technique. A sample size of 334 calculated using epi-info statistical software using P of 32% based on a similar study from Republic of South Africa. Expected results and dissemination of results: This study expects to find high rates of Caesarean sections at Queen Elizabeth Central Hospital and with age distribution analysis for both the rates, indications and outcomes, it is expected that most burden will be amongst the young age category as they are not mature enough to mostly undergo vaginal birth. Amongst rural and urban population, it is expected mostly for the outcomes to be worse for most rural populations because of distance factor and the quality health personnel of the entry level facilities that they access. For all aspects of analysis for each objective (Rates, Indications and outcomes), P-values and confidence intervals will be calculated to determine the statistical significances of the different proportions. The findings of the study will be presented at the Obstetrics and gynaecology department of the Queen Elizabeth Central Hospital (QECH) in Blantyre and if possible at the research dissemination conference (RDC) at College of Medicine Blantyre campus. The detailed report for the findings will be submitted to the following departments, Obstetrics and Gynaecology departments of QECH, College of Medicine Library and College of Medicine Research and Ethics Committee (COMREC). We are also hoping to publish our research in the Malawi Medical Journal through Young Researchers Forum (YRC). A retrospective study of caesarean sections at Queen Elizabeth Central Hospital