This pilot study aims to investigate the distribution and determinants of Caesarean-related infections in Rwanda, a country with a high Caesarean delivery (CD) rate, estimated at 21% or even higher in some facilities. The study is motivated by the increased risk of postpartum infections associated with CD, which can lead to serious health consequences, including maternal and neonatal mortality. Notably, sepsis alone accounts for over 20% of maternal deaths in sub-Saharan Africa.
Existing research on post-CD infections in sub-Saharan Africa has limitations, such as small sample sizes, retrospective designs, and inconsistent definitions of infection. Therefore, this pilot study focuses on uncovering the prevalence and distribution of post-CD infections and their causal factors in Rwanda. The primary objective is to determine the frequency, type, and severity of post-CD infections in pilot facilities.
The study will include retrospective review of delivery registries, one-time hospital assessments using the World Health Organization's Service Availability and Readiness Assessment (SARA) survey, and a prospective observational cohort study involving data collection from all CD cases in district hospitals and admissions for post-CD infections in larger hospitals. The data collected will help map common care pathways to infections following CD and will be analyzed using multivariate statistical models.
This research is crucial for improving maternal and neonatal health in Rwanda by identifying the factors contributing to post-CD infections and their impact on morbidity and mortality. Ultimately, the study will inform healthcare practices and policies to reduce the burden of post-CD infections in the region.
Funding for this study is provided by the BC Children's Hospital Research Institute Healthy Starts Theme Catalyst Grant Award, and data collection is expected to take no more than 2 weeks per site. The study sites include several major hospitals in Rwanda, and data collection will span a 6-month period.