Models using private general practitioners to provide caesarean deliveries at five South African district public hospitals: insights for public-private contracting for obstetric care in rural areas.

Background: Harnessing of private sector resources could play an important role in efforts to promote universal access to safe obstetric care including caesarean delivery in low- and middle-income countries especially in rural contexts but any such attempt would need to ensure that the care provided is appropriate and patterns of inappropriate care, such as high caesarean delivery rates, are not reproduced for the entire population.

Objective: To examine the contracting arrangements for using private general practitioners to provide caesarean delivery services in rural district hospitals in South Africa.

Method: We utilised a mixed-method study design to examine the contracting models adopted by five rural district hospitals in the Western Cape, South Africa.