| 1 | less than 2% |
| 2 | 2% to 4.9% |
| 3 | 5% to 9.9% |
| 4 | 10% to 14.9% |
| 5 | 15% to 24.9% |
| 6 | 25% to 34.9% |
| 7 | 35% or over |
| 8 | No Data |
| 1 | Less than 20% |
| 2 | 20 to 49% |
| 3 | 50% to 74% |
| 4 | 75% to 94% |
| 5 | 95% or more |
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Births by Caesarean Section
What does it mean ?
This indicator shows the number of births by caesarean section relative to all births. Birth by caesarean section requires specialist health worker skills, an operating theatre and availability of specific drugs and medical products.
Why does it matter ?
All pregnancies are associated with risk and when medically justified, a caesarean section can prevent maternal and perinatal mortality and morbidity. However, because any surgery carries risk of complications, caesarean sections should not be performed unless it is medically required. According to the World Health Organisation, about 10-15 % of all births require delivery by caesarean section. As such, caesarean section rates lower than 10% indicates under-use and caesarean section rates over 15 % indicate over-use. Because birth by caesarean section requires specialist medical skills and health services, this indicators is sometimes used as a proxy indicator to measure the availability of quality of maternal health services in countries where data from health information systems and health facility surveys are limited.
How is it collected ?
Data on the percent of birth by caesarean section is usually derived from large scale, nationally representative surveys such as Demographic and Health (DHS) and Multiple Indicator Cluster Surveys (MICS), other national surveys. DHS/ MICS are household surveys where women are asked if they have given birth (usually in the last three or five years) and the circumstances surrounding the birth including if they had a caesarean section.
"The Increasing Trend in Caesarean Section Rates: Global, Regional and National Estimates: 1990-2014" Betrán, A., et al. PLoS One. 2016; 11(2): http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4743929/
Percent of Births Attended by Skilled Personnel
What does it mean ?
This indicator shows the percentage of births that take place in the presence of a skilled healthcare worker who is qualified to attend to births. The definition of a skilled birth attendant is an accredited health professional – such as a midwife, nurse or doctor – who has the necessary skills needed to manage normal pregnancy, childbirth and the period after the birth, and who is able to identify, manage and refer women and newborns if complications occur.
Why does it matter ?
All women should have skilled care during pregnancy and childbirth because the provision of skilled care at every birth significantly reduces the risk of maternal and newborn mortality. This indicator can also give us information on the use of maternity services in a country, and can measure a health system's ability to provide good care during childbirth. Skilled attendance is a crucial factor in reducing maternal and newborn death.
How is it collected ?
A national survey was undertaken in each country from a representative sample of households where women and girls were asked how many babies they have given birth to and when their births occurred. Additional questions were asked about the circumstances at each birth and whether a doctor, midwife, nurse or other skilled person was present. The indicator concerns births that occurred in the three years before the survey.
World Health Organization, Global Health Observatory data repository, accessed in August 2016 http://apps.who.int/gho/data/node.main.REPWOMEN39?lang=en
