Applying the dynamic performance management approach to cesarean reduction policies: An analysis of the maternity pathway in a local health authority

Since last three decades, the World Health Organisation strongly encourages countries to reduce the Caesarean Section (CS) rate down to 10-15%. However, this goal nowadays appears still far from its achievement. Public decision makers are still struggling to design and implement effective policies to reduce the CS rate. This study, based on the analysis of the maternity pathway recently introduced in Sicily, applies the Dynamic Performance Management approach to investigate the drivers impacting on the CS. Such analysis provided the basis to build a System Dynamics model customised on a local health authority. Simulation results reveal that to effectively reduce the CS rate implemented policies should favour a coordination of the actors playing a crucial role in the maternity pathway.