Caesarean section rates in South Africa : a case study of the health systems challenges for the proposed National Health Insurance

• Published in: South African medical journal Vol. 110; no. 8; pp. 747 - 750
• Main Authors: Solanki, G.C., Fawcus, S., Daviaud, E., Cornell, J.E.
• Format: Journal Article
• Language: English
• Published: South African Medical Association NPC 01-08-2020; Health & Medical Publishing Group
• Subjects: Analysis; Case studies; Cesarean section; Health care industry; National health insurance; Australia; South Africa; Sub-Saharan Africa
• ISSN: 0256-9574; 2078-5135
• DOI: 10.7196/SAMJ.2020.v110i8.14699

Broader policy research and debate on the issues related to the planning of National Health Insurance (NHI) in South Africa (SA) need to be complemented by case studies to examine and understand the issues that will have to be dealt with at micro and macro levels. The objective of this article is to use caesarean section (CS) as a case study to examine the health systems challenges that NHI would need to address in order to ensure sustainability. The specific objectives are to: (i) provide an overview of the key clinical considerations related to CS; (ii) assess the CS rates in the SA public and private sectors; and (iii) use a health systems framework to examine the drivers of the differences between the public and private sectors and to identify the challenges that the proposed NHI would need to address on the road to implementation.