The share of deliveries through caesarean section in the country has surged to a high of 18.25 percent of all births, putting pressure on medical insurers’ bottom lines, as fewer women opt for natural delivery.
Recently published Kenya National Bureau of Statistics (KNBS) data shows the share of C-Sections in the total births rose for the fifth straight year to 18.25 percent at the end of last year, marking more than double the 9 percent the country had a decade ago.
A caesarean section is a surgical procedure involving incision of a mother’s abdomen and uterus to deliver one or more babies. C-sections are justified in situations where normal deliveries pose risks to the mother or the newborn.
The 18.25 percent rate is higher than the World Health Organisation’s (WHO) ideal rate of within 10 percent and 15 percent—a trend which has alarmed insurance companies who have to spend billions of shillings annually to foot C-section hospital bills.
Of the 1.208 million hospital deliveries that Kenya had last year, 220,505 were through C-section compared with 219,112 a year earlier and 110,900 in 2014 when the total deliveries in hospitals were 895,400.
Disclosures by hospitals such as MP Shah, Aga Khan Hospital, Nairobi Hospital and Mater, show their C-sections require at least Sh220,000, with emergency C-sections going above Sh300,000.
The charges are in contrast with normal deliveries that range between Sh80,000 and Sh100,000 in the same hospitals.
For instance, at Nairobi Hospital, C-sections are priced at Sh240,000 excluding daily bed charges of between Sh11,000 and Sh26,000. The same hospital charges Sh125,000 for normal delivery.
MP Shah charges Sh225,000 for C-section compared with Sh110,000 for normal deliveries. Nairobi West Hospital charges between Sh182,000 and Sh318,000 for C-section while normal deliveries cost between Sh62,000 and Sh130,000.
The rising share of C-sections in hospitals has left insurers with higher bills to foot, hurting their financial performance.
Insurance Regulatory Authority data shows medical insurers have seen claims, including those from C-sections, more than double over the past five years to Sh44.62 billion from Sh20.4 billion, pushing them into underwriting losses.
KNBS 2022 Demographic and Health survey showed C-sections in 19 counties were above the WHO limit of 15 percent compared with 2014, when only five counties were in breach.
Kirinyaga County has the highest C-sections rate (40 percent) followed by Kiambu (33 percent), Tharaka-Nithi (30 percent), Nairobi (28 percent) and Taita/Taveta (27 percent).
KNBS data shows the C-section prevalence increases with the woman's age, education level, number of antenatal care visits and the wealth status.
About 33 percent of live births for women in the highest wealth quintile were delivered by C-section compared with five percent of the births for women in the lowest wealth quintile.
Women classified as poor, with little or no education and residing in rural areas, record lower levels of C-section, suggesting that social status and medical cover has a big influence on the method of delivery.
