@article{fdi:010066179,
  title = {{A} global reference for caesarean section rates ({C}-{M}odel) : a multicountry cross-sectional study},
  author = {{S}ouza, {J}. {P}. and {B}etran, {A}. {P}. and {D}umont, {A}lexandre and de {M}ucio, {B}. and {P}ickens, {C}. {M}. {G}. and {D}eneux-{T}haraux, {C}. and {O}rtiz-{P}anozo, {E}. and {S}ullivan, {E}. and {O}ta, {E}. and {T}ogoobaatar, {G}. and {C}arroli, {G}. and {K}night, {H}. and {Z}hang, {J}. and {C}ecatti, {J}. {G}. and {V}ogel, {J}. {P}. and {J}ayaratne, {K}. and {L}eal, {M}. {C}. and {G}issler, {M}. and {M}orisaki, {N}. and {L}ack, {N}. and {O}ladapo, {O}. {T}. and {T}uncalp, {O}. and {L}umbiganon, {P}. and {M}ori, {R}. and {Q}uintana, {S}. and {P}assos, {A}. {D}. {C}. and {M}arcolin, {A}. {C}. and {Z}ongo, {A}. and {B}londel, {B}. and {H}ernandez, {B}. and {H}ogue, {C}. {J}. and {P}runet, {C}. and {L}andman, {C}. and {O}chir, {C}. and {C}uesta, {C}. and {P}ileggi-{C}astro, {C}. and {W}alker, {D}. and {A}lves, {D}. and {A}balos, {E}. and {M}oises, {E}. {C}. {D}. and {V}ieira, {E}. {M}. and {D}uarte, {G}. and {P}erdona, {G}. and {G}urol-{U}rganci, {I}. and {T}akahiko, {K}. and {M}oscovici, {L}. and {C}ampodonico, {L}. and {O}liveira-{C}iabati, {L}. and {L}aopaiboon, {M}. and {D}anansuriya, {M}. and {N}akamura-{P}ereira, {M}. and {C}osta, {M}. {L}. and {T}orloni, {M}. {R}. and {K}ramer, {M}. {R}. and {B}orges, {P}. and {O}lkhanud, {P}. {B}. and {P}erez-{C}uevas, {R}. and {A}gampodi, {S}. {B}. and {M}ittal, {S}. and {S}erruya, {S}. and {B}ataglia, {V}. and {L}i, {Z}. and {T}emmerman, {M}. and {G}ulmezoglu, {A}. {M}.},
  editor = {},
  language = {{ENG}},
  abstract = {{O}bjective{T}o generate a global reference for caesarean section ({CS}) rates at health facilities. {D}esign{C}ross-sectional study. {S}etting{H}ealth facilities from 43 countries. {P}opulation/{S}ample{T}hirty eight thousand three hundred and twenty-four women giving birth from 22 countries for model building and 10045875 women giving birth from 43 countries for model testing. {M}ethods{W}e hypothesised that mathematical models could determine the relationship between clinical-obstetric characteristics and {CS}. {T}hese models generated probabilities of {CS} that could be compared with the observed {CS} rates. {W}e devised a three-step approach to generate the global benchmark of {CS} rates at health facilities: creation of a multi-country reference population, building mathematical models, and testing these models. {M}ain outcome measures{A}rea under the {ROC} curves, diagnostic odds ratio, expected {CS} rate, observed {CS} rate. {R}esults{A}ccording to the different versions of the model, areas under the {ROC} curves suggested a good discriminatory capacity of {C}-{M}odel, with summary estimates ranging from 0.832 to 0.844. {T}he {C}-{M}odel was able to generate expected {CS} rates adjusted for the case-mix of the obstetric population. {W}e have also prepared an e-calculator to facilitate use of {C}-{M}odel (). {C}onclusions{T}his article describes the development of a global reference for {CS} rates. {B}ased on maternal characteristics, this tool was able to generate an individualised expected {CS} rate for health facilities or groups of health facilities. {W}ith {C}-{M}odel, obstetric teams, health system managers, health facilities, health insurance companies, and governments can produce a customised reference {CS} rate for assessing use (and overuse) of {CS}. {T}weetable abstract{T}he {C}-{M}odel provides a customized benchmark for caesarean section rates in health facilities and systems. {T}weetable abstract {T}he {C}-{M}odel provides a customized benchmark for caesarean section rates in health facilities and systems.},
  keywords = {{B}enchmarking ; caesarean delivery rates ; caesarean section rates ; logistic regression ; {MONDE}},
  booktitle = {},
  journal = {{BJOG} : {I}nternational {J}ournal of {O}bstetrics and {G}ynaecology},
  volume = {123},
  numero = {3},
  pages = {427--436},
  ISSN = {1470-0328},
  year = {2016},
  DOI = {10.1111/1471-0528.13509},
  URL = {https://www.documentation.ird.fr/hor/fdi:010066179},
}