Sexual and reproductive health

Tool to calculate caesarean section reference rates at health facilities is launched: the C-Model

A gynaecologist and a doctor perform a caesarean section, Bangladesh.
It is often difficult to determine an appropriate rate of caesarean section for individual health facilities.
UNICEF/Noorani

Caesarean section is one of the most commonly performed surgical operations in the world. The WHO statement on caesarean section stresses that efforts should be placed to provide caesarean section to all women in need, rather than striving to achieve a specific rate and that it should only be performed when medically necessary.

Welcome to C-Model

By selecting the relevant conditions, the C-Model will calculate the C-Section probability

Recent ecologic data from WHO Department of Reproductive Health and Research including HRP show that when caesarean section rates rise towards 10% across a population (e.g. a country), the number of maternal and newborn deaths decreases. When the rate goes above 10%, there is no evidence that mortality rates improve. Due to differences in the cases and obstetric profile of mothers however, it is often difficult to determine an appropriate rate of caesarean section for individual health facilities.

A new mathematical model has now been launched to address this issue. Known as the C-Model, and developed by WHO RHR / HRP and partners, the tool is able to estimate the expected caesarean section rate in health facilities according to the characteristics of the population that they serve (obstetric case-mix).

The tool works as a calculator which can help obstetric teams, health system managers, health facilities, researchers and governments to produce a customized reference for the rate of caesarean sections. This data can therefore help people worldwide working across sectors to assess the use and / or overuse of caesarean sections in specific contexts.

This is important, not for health facilities to strive to achieve a specific rate, but to ensure that caesarean sections are provided to the women in need.

The development process of the C-Model, has been published in the journal BJOG: An International Journal of Obstetrics and Gynaecology. The C-Model was tested in a collaborative database of 10 045 875 women giving birth from 43 countries, and the tool was built with data from 38,324 women from 22 countries.