Cyprus tackles soaring caesarean section rates with financial incentives

Cyprus is battling a surge in caesarean sections, with rates far exceeding the European Union average, prompting the Ministry of Health and Health Insurance Organisation (HIO) to develop a national strategy and financial incentive plan.

Data from the Health Monitoring Unit of the Ministry of Health reveals that the caesarean section rate in Cyprus reached 59% in 2021, while the EU average remained below 30%.

This trend continued in 2022 and 2023, with rates of 60% and 62.31% respectively, according to the Statistical Service and GESY software.

In response, the HIO has proposed a system of rewards and penalties for gynaecologists, based on their individual rates of non-emergency caesarean sections.

Doctors maintaining rates below 30% could see their reimbursements increase by up to 15%, while those exceeding 40% could face reductions of up to 35%.

“The Ministry of Health, in collaboration with all stakeholders, has completed a national strategy to promote normal delivery and reduce prematurity,” the HIO stated. “This strategy includes a number of actions, some of which have been assigned to HIO for evaluation and implementation.”

The proposed plan is currently under discussion with doctors. Previous efforts to promote normal delivery have not yielded significant results, with data from the Ministry of Health indicating that only 15%-17% of caesarean sections in 2022 were performed for medical necessity.

The HIO will monitor the rates of non-emergency caesarean sections on a monthly basis, providing aggregate statements to doctors and hospitals.

At the end of each year, incentives or disincentives will be applied to hospitals, which will then affect the doctors’ reimbursements.