Promoting Normal Birth and Reducing Caesarean Section Rates: An Evaluation of the Rapid Improvement Programme
Graham Cookson and Ioannis Laliotis
This paper seeks to evaluate the impact of the 2008 Rapid Improvement Programme that aimed in promoting normal birth and reducing caesarean section rates in the English NHS. Using Hospital Episode Statistics data and combining difference-in-differences with propensity score matching estimators, the average treatment effect on the treated is found to be small, significant and short-lived. The uncovered reduction concerned the overall and the planned trust-level caesarean section rates and it occurred only shortly after the programme implementation. No effect was found in the case of the emergency caesarean section rate.