Methods
HMIS data for total, public, and private CS surgeries for nine financial years (2011-2019) for 737 districts across 37 states was taken from the National Data and Analytics Platform. Annual CS rates were defined as the number of CS surgeries per 100 live births. For public and private CS rates, since sector-wise live births were unavailable, we used the sector-wise deliveries multiplied by the ratio of total deliveries to the total live births. District-level data were aggregated for estimating state and national rates. CS rates less than 10% were defined as inadequate - needing scale-up.3Rates over 19% were defined as excess.4Unweighted average annual percent changes were computed for CS rates. Public-private CS rate comparisons were conducted using unpaired Wilcox tests. All analysis and visualization were performed in R.