Abstract for: Designing healthcare policies to reduce caesarean sections: an empirical analysis

Designing effective policies in healthcare has proven to be a controversial task. This is particularly true in presence of phenomena characterized by multiple cause-and-effect relationships driving system behaviour performance and time delays between policy and related effects. The growing trend recorded worldwide in caesarean births in the last decades, in spite of the efforts made by countries to tackle it, shows the above peculiarities. To deal with such a complex and dynamic phenomenon, the authors developed a System Dynamics simulation model. In the model building process, strategic resources and related performance drivers impacting on outcomes are made explicit through a feedback perspective. The simulation model aims to support policy makers’ learning processes in better understanding how to design and assess caesarean births reduction policies. Such a model focuses on a local health authority sited in Sicily (Italy), where a maternity pathway to reduce caesarean sections has been recently introduced. Through the use of the System Dynamics model alternative investment policies have been explored. Findings emerging from simulation results suggest that the adoption of a balanced investment policy among the key actors involved in the maternity pathway is likely to generate a remarkable reduction in caesarean births.