-Prishtina, December 07, 2017

The round table on Cesarean birth deliveries in Kosovo was held today with healthcare professionals, policymakers and civil society representatives, organized by Action for Mothers and Children and Solidar Suisse.

In the last decade, Caesarean births have been growing steadily in Kosovo, with percentage increase from 7.5 to 27.3% for the years 2000 to 2015. The current rate overpasses the international recommendations. The factors increasing C-section rates include health system factors ranging from micro, meso and macro levels of our healthcare.

Our panelist, Prof. Dr. Sejdullah Hoxha, gynecologist, said that “compared to the pre-war period, the role of midwives in patient education has been disempowered, thus in many cases the patient insists on cesarean birth due to lack of information.” Dr.Hoxha at the same time emphasized that Cesarean rates can be reduced if we work in strengthening the cooperation between the Association of Gynecologists, the Midwives Association and the Association of Anesthesiologists in the country.

Mrs. Magbule Elezi, Head of the Midwives Association, also emphasized the importance of building infrascrutcutres that encourage midwife-patient communication, as the asymmetry of information is leading patients towards uninformed decisions on birth delivery modes.

Prof. Dr. Ilir Hoxha from Solidar Suisse, who is also a researcher of systemic factors in clinical procedures, listed the factors that are causing the increase of Ceasarean section rates which range from hospital status, possession of private health insurance of the patient, patient’s socio-economic status, asymmetry of information, and hospital supplies. “Evidence shows that the private hospital statute is positively correlated with the C-section rates as well as patient’s possession of private health insurance.” Dr. Ilir Hoxha concluded his presentation pointing out that unnecessary clinical procedures, such as Cesarean procedures, that are more expensive, cause a financial burden in healthcare systems and unnecessary expenses that could otherwise be reallocated for quality improvement of healthcare.

Dr. Sami Uka, from the World Health Organization – WHO, spoke on the importance of national guidelines and standardized protocols and their implementation in the system. Dr. Uka also recommended the adoption of a monitoring tools developed by WHO for accurate and transparent evaluation of protocol implementation, which has also been recommended to the Ministry of Health.

Mr. Agron Bytyqi, from the Patients Rights Association, mentioned some of the categories of patients complaints, pointing out inefficient and delayed clinical services, referrals from public to private hospitals for clinical procedures, and poor doctor-patient communication. He also emphasized the commercialization of Cesarean deliveries from private hospitals in the country providing financial incentives to women and girls which affects hence maternal choice for C-section.

Birth deliveries via Ceasarean section have short and long term health consequences for mothers and children, sush as possible surgical complications, need for neonatal intensive care, as well as unnecessary financial costs compared to normal deliveries.