Caesarean deliveries increasing in Libya

The rate of delivery of caesarean sections, within the private health sector institutions in Libya, has increased by 90 per cent, compared to 2017, according to a recent study. A study by the Documentation and Information Centre of the Ministry of Health of the Government of National Accord (GNA) in Tripoli, in cooperation with the European Union and the World Health Organization, showed that the number of caesarean sections reached 6478. This is compared to 3404 in a previous survey in 2007. The study continues: “The total number of registered births in 219 medical centres reached 13,384, including 6,478 caesarean deliveries, indicating that the caesarean section constitutes 48 per cent of all deliveries.”

The study added: “Caesarean deliveries in 2007 were 10,867 cases, which accounted for 31 per cent at the time.” It concludes by warning that the death rate in private clinics due to caesarean sections was 3.2 per 1,000 births in 2007, though it did not reveal the death rate in the main findings of the recent study.

Ramzi Bouseta, a Libyan doctor, said that the study is a ringing alarm, indirectly indicating the risk of death among the newborns by this type of delivery, and the fact that the study does not mean the rate of fatalities in Caesareans makes it incomplete.

He added: “Not mentioning the rate of death in this study is perhaps deliberate so as not to raise an issue in the public opinion, but the study is certainly serious and conveys many messages.” He explained that the study focused on private health institutions and pointing to the mortality rate in the previous survey in 2007 without referring to the deaths of the current research.”

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Dr. Bousetta explains that “the ministry can no longer curb the infringements of private clinics that put citizens at risk and announce from the invisible side the danger of the opting for caesarean delivery in the clinics, most of which do not have adequate rehabilitation instruments, on top of which the lack of neonatal incubators that provide special conditions for a baby newly born in an unnatural way.

Abdel Kader Al-Ammouri, an official in the inspection and follow-up department at the Ministry of Health, pointed out that, in light of the administrative division in the country, government departments do not have a database that identifies even the number of private clinics in Libya. A number of these clinics have not renewed their licenses, while others are not also subject to monitoring and follow-up.

He continued that the authorities of the Ministry of Health in the government cannot reach areas controlled by armed groups currently fighting a war on the borders of Tripoli.

As for the clinics in the capital Tripoli, Al-Ammouri says: “There is a relative control, but there is circumvention on the other hand. The conditions of war and the collapse of the public health sector force the authorities not to deal firmly with the private sector because it is covering a large deficit.”

He went on: “The problem is not about the availability of devices, but it is about the way to assess the staff of these private clinics, as disasters occur there and they are escaped through the loopholes of the law to be classified as medical errors.”

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This is confirmed by Dr Ramzi Bousetta, who said that resorting to private clinics for Caesarean deliveries puts the mother and her baby at risk of death in the absence of qualified staff, pointing out that one of the reasons for resorting to private clinics in the state of deficit in the public sector.

The private sector section of the Health Services Department in Tripoli announced, last year, the closure of several clinics for violating the regulations and legal standards, including ten clinics with a Libyan-foreign partnership.

The department pointed out that the reasons for the closure were the seizure of irregularities in the form of expired medical supplies and laboratories tools, in addition to the failure of clinics to meet the conditions of registration and the unavailability of medical personnel, and medical assistance permission to practice the profession.

Although the announcement was part of what the sector called the “First Campaign”, the next campaigns have not yet been announced. However, Dr Bousetta said that caesarean deliveries are frequent and that private clinics make it a more accessible option for the mother.