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CONFERENCE PROCEEDING
Prospective audit and feedback approach within the Easy-Net network program: Effectiveness in improving obstetric practice and reducing cesarean section rates in the Italian Calabria Region
1
Italian National Institute of Health, National Center for Disease Prevention and Health Promotion, Rome, Italy
2
University of Rome Tor Vergata, Department of Biomedicine and Prevention, Rome, Italy
3
Calabria Region, Health Protection Department, Catanzaro, Italy
4
Italian National Institute of Health, Technical-Scientific Statistical Service, Rome, Italy
Eur J Midwifery 2026;10(Supplement 1):A497
ABSTRACT
BACKGROUND:
Italy reports one of the highest cesarean section (CS) rates in Europe, with wide regional disparities. In the Calabria Region, CS rates are among the highest, often lacking clinical justification. Audit and Feedback (A&F) is a proven strategy for promoting adherence to evidence-based practices and improving care quality.
OBJECTIVES:
To evaluate the effectiveness of a structured, multi-level A&F intervention in reducing inappropriate CS rates and supporting obstetric practice improvement in the Calabria Region, within the “Easy-Net” Network Program (NET-2016-02364191).
METHODS:
The project was conducted in 3 phases: (1) pre-intervention analysis of birth registry data; (2) implementation of an A&F strategy targeting healthcare professionals (HCPs) and pregnant women, including monthly A&F meetings with external facilitation, training, and a regional communication campaign; (3) post-intervention assessment and SWOT analysis. Mixed methods included quantitative data analysis, surveys assessing HCPs' knowledge, attitudes and practices, alongside qualitative insights from mothers and HCPs on CS decision-making.
RESULTS:
Pre-intervention data showed CS rates exceeding 38% in several facilities, with inter-regional variation. Most HCPs reported limited prior exposure to A&F, insufficient access to routine data, and inconsistent application of the Robson classification. Post-intervention data from 2023 indicates a decline in CS rates (35.8%), with the most significant reductions observed in Robson groups involving primiparous and labour induction, aligning with A&F activities, training efforts, and newly developed regional protocols for appropriate labour induction and physiological pregnancy care.
CONCLUSIONS:
A structured A&F approach, complemented by communication strategies and HCP training, shows potential to reduce inappropriate CS and improve perinatal care. Integrating mothers' and HCPs' perspectives was essential for fostering sustainable improvements.
KEY MESSAGE:
Prospective, participatory A&F interventions appears feasible and impactful in reducing inappropriate CS and enhancing perinatal care . Poster session 1 (Group A)
Italy reports one of the highest cesarean section (CS) rates in Europe, with wide regional disparities. In the Calabria Region, CS rates are among the highest, often lacking clinical justification. Audit and Feedback (A&F) is a proven strategy for promoting adherence to evidence-based practices and improving care quality.
OBJECTIVES:
To evaluate the effectiveness of a structured, multi-level A&F intervention in reducing inappropriate CS rates and supporting obstetric practice improvement in the Calabria Region, within the “Easy-Net” Network Program (NET-2016-02364191).
METHODS:
The project was conducted in 3 phases: (1) pre-intervention analysis of birth registry data; (2) implementation of an A&F strategy targeting healthcare professionals (HCPs) and pregnant women, including monthly A&F meetings with external facilitation, training, and a regional communication campaign; (3) post-intervention assessment and SWOT analysis. Mixed methods included quantitative data analysis, surveys assessing HCPs' knowledge, attitudes and practices, alongside qualitative insights from mothers and HCPs on CS decision-making.
RESULTS:
Pre-intervention data showed CS rates exceeding 38% in several facilities, with inter-regional variation. Most HCPs reported limited prior exposure to A&F, insufficient access to routine data, and inconsistent application of the Robson classification. Post-intervention data from 2023 indicates a decline in CS rates (35.8%), with the most significant reductions observed in Robson groups involving primiparous and labour induction, aligning with A&F activities, training efforts, and newly developed regional protocols for appropriate labour induction and physiological pregnancy care.
CONCLUSIONS:
A structured A&F approach, complemented by communication strategies and HCP training, shows potential to reduce inappropriate CS and improve perinatal care. Integrating mothers' and HCPs' perspectives was essential for fostering sustainable improvements.
KEY MESSAGE:
Prospective, participatory A&F interventions appears feasible and impactful in reducing inappropriate CS and enhancing perinatal care . Poster session 1 (Group A)
| eISSN: | 2585-2906 |
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