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Vol. 61 No. 3 (2025)
DOI: 10.4415/ANN_25_03_08
Original Articles
2025-09-16
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Healthcare professionals’ perceptions of caesarean section decision-making and the implementation of Audit&Feedback strategies in the Calabria Region: a qualitative study

Authors

Vincenza Di Stefano , Jessica Preziosi , Francesca Zambri , Gabriella Tambascia , Paola Scardetta , Edoardo Corsi Decenti , Flavia Splendore , Alice Maraschini , Daniela Lico , Erika Rania , Deborah Considerato , Roberta Venturella , Serena Donati , Anna Domenica Mignuoli , Angela Giusti , EASY-NET Working Group

Abstract

Introduction. Calabria Region has one of the highest caesarean section (CS) rate in Italy. To encourage the implementation of Audit&Feedback strategies, this study aimed to explore factors influencing CS decision-making from healthcare professionals’ perspectives.
Method. A descriptive qualitative study was conducted through focus groups (FGs) with healthcare professionals (HPs) from 11 Maternity Units and 3 Community Health Services for Families of Calabria, from February to April 2021.
Results. Six FGs were carried out, involving 92 HPs. Main determinants influencing high CS rates included medicalization of birth, reported women’s fear of childbirth, family pressure, cultural beliefs, organizational issues, and medico-legal concerns. HPs emphasized teamwork, midwifery-led low-risk pathways, training, and audits to reduce CS rates and improve quality of care.
Conclusions. This study identified determinants influencing CS decision-making in Calabria highlighting opportunities to reduce CS through empowering education, shared protocols, and women’s active involvement in decision-making process. Audit&Feedback strategies could improve health outcomes.

 

Keywords: caesarean section, audit and feedback, qualitative study

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Authors

Vincenza Di Stefano - National Centre for Disease Prevention and Health Promotion, Italian National Institute of Health, Rome, Italy; Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy

Jessica Preziosi - Department of Woman, Child and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy

Francesca Zambri - National Centre for Disease Prevention and Health Promotion, Italian National Institute of Health, Rome, Italy

Gabriella Tambascia - National Centre for Disease Prevention and Health Promotion, Italian National Institute of Health, Rome, Italy; Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy

Paola Scardetta - National Centre for Disease Prevention and Health Promotion, Italian National Institute of Health, Rome, Italy

Edoardo Corsi Decenti - National Centre for Disease Prevention and Health Promotion, Italian National Institute of Health, Rome, Italy

Flavia Splendore - National Centre for Disease Prevention and Health Promotion, Italian National Institute of Health, Rome, Italy; Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy

Alice Maraschini - Technical-Scientific Statistical Service, Italian National Institute of Health, Rome, Italy

Daniela Lico - “Pugliese-Ciaccio” Hospital, Catanzaro, Italy

Erika Rania - “Pugliese-Ciaccio” Hospital, Catanzaro, Italy

Deborah Considerato - “Pugliese-Ciaccio” Hospital, Catanzaro, Italy

Roberta Venturella - Department of Clinical and Experimental Medicine, Magna Graecia University of Catanzaro, Italy

Serena Donati - National Centre for Disease Prevention and Health Promotion, Italian National Institute of Health, Rome, Italy

Anna Domenica Mignuoli - Health Protection Department of the Calabria Region, Catanzaro, Italy

Angela Giusti - National Centre for Disease Prevention and Health Promotion, Italian National Institute of Health, Rome, Italy

EASY-NET Working Group

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Copyright (c) 2025 Istituto Superiore di Sanità

How to Cite
Di Stefano, V., Preziosi, J., Zambri, F., Tambascia, G., Scardetta, P., Corsi Decenti, E., Splendore, F., Maraschini, A., Lico, D., Rania, E., Considerato, D., Venturella, R., Donati, S., Mignuoli, A. D., Giusti, A., & Working Group , E.-N. (2025). Healthcare professionals’ perceptions of caesarean section decision-making and the implementation of Audit&Feedback strategies in the Calabria Region: a qualitative study . Annali dell’Istituto Superiore Di Sanità, 61(3), 215–225. https://doi.org/10.4415/ANN_25_03_08
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