The acceptable rate of Caesarean Section (CS) by World Health Organization(WHO) is considered between 10% and 15%. But the C-section is increasingly common in Pakistan as well as in Punjab. Although, medically it is sometimes justified that a caesarean section is helpful to prevent child and maternal mortality. However, it also has witnessed that C-section is harmful for women or infants who do not require the procedure. Because it is linked with short term and long-term health hazard/risk which can outspread over many years out there the current delivery. It can affect not only the health of woman but also her child. 

The rise in C-sections is primarily because of private hospitals, where patients pay out of pocket expenditures. The corresponding cesarean rates for private hospital-based deliveries are witnessed to be higher than the rates in Public sector hospitals and the rate has increased rapidly from a low level of 35 percent in the 2011 to 46.3 in 2017 in Punjab. While the C-section rates in public sector hospital has been observed to have declined from 32 percent in the 2014 (MICS) to 28 percent in (Punjab Health Survey) 2017. 

Additional concerns and controversies surrounding CS include inequities in the use of the procedure within the districts in Punjab. However, any gone up in the C-section rates in these districts, is not accompanying to rise in infant survival rates. The highest increase can be seen in women of Gujrat with 48.2 percent in 2017 increase from 26.3 percent in 2011. Similar pattern of increase can be observed in case of Lahore with 68 percent increase in C-section rate between 2011-2016. while the lowest can be observed in the Dera Ghazi Khan District with 7.7 in 2017 against 5.9 percent in 2011. 

Further research is needed to explore cost differences in private and public-sector hospitals for both natural delivery and C-section. Furthermore, the future trends in the magnitude of these inequalities and its impact on patients, economic and physical health also needed to be explored. 


Lahore, May 20.