The QUALI-DEC project

Despite long-standing international concerns and debates, the proportion of caesarean births continues to rise. This trend is not limited to high-income countries, but is largely concentrated in low- and middle-income countries. Abuse of Caesarean sections diverts scarce resources and thus reduces access to care for women who really need it. Argentina, Burkina Faso, Thailand and Vietnam have committed themselves to reducing unnecessary C-sections, but many individual and organizational factors in health facilities hinder this goal. Non-clinical interventions can overcome these barriers by helping providers and women to choose the best method of delivery. Existing evidence has shown only a modest effect of these interventions on reducing Caesarean section rates, probably due to the failure to design effective interventions tailored to the context. The objective of the Qualidec project is to design, adapt and test an intervention for the appropriate use of Caesarean section in Argentina, Burkina Faso, Thailand and Vietnam.

What research are we conducting?

Based on the recommendations of the World Health Organization (WHO) and scientific studies, our intervention strategy consists of four components:

  • The use of opinion leaders to encourage evidence-based clinical practice.

  • Review of caesarean section indications by the caregivers themselves with feedback to the whole team (audit & feedback) to avoid unnecessary interventions.

  • Support by a relative to reassure the woman during labour.

  • A decision support tool to encourage dialogue between caregivers and women during pregnancy monitoring.

This strategy takes into account women’s needs, institutional resources and the organisation of care in each country. A hybrid evaluation of implementation and effectiveness will identify the success factors of the project and make recommendations for its wider replication.

Countries in which we operate:

Link to external sites

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