Caesarean section rates in Mozambique
Identifieur interne : 003376 ( Ncbi/Curation ); précédent : 003375; suivant : 003377Caesarean section rates in Mozambique
Auteurs : Qian Long [Finlande] ; Taina Kempas [Finlande] ; Tavares Madede [Mozambique] ; Reija Klemetti [Finlande] ; Elina Hemminki [Finlande]Source :
- BMC Pregnancy and Childbirth [ 1471-2393 ] ; 2015.
Abstract
The Caesarean section (C-section) rate is used as an indicator for availability and utilization of life-saving obstetric services. The purpose of the present study was to explore changes in C-section rates between 1995 and 2011 by area, place of delivery and maternal socioeconomic factors in Mozambique.
Cross-sectional data from the Demographic and Health Surveys conducted in Mozambique in 1997, 2003 and 2011 were used, including women having a live birth within 3 years prior to the survey. Descriptive statistics and logistic regressions were used to identify factors associated with having a C-section.
The C-section rate decreased slightly from 2.5 % in 1995–1997 to 2.1 % in 2001–2003 and then increased to 4.7 % in 2009–2011. In 2009–2011, C-section rates ranged in urban areas from 4.6 % in the northern region to 12.2 % in the southern region and in rural areas from 1.6 % in the northern region to 3.9 % in the southern region. 12.3 % of the richest women had had a C-section, compared to 1.7 % of the poorest women. C-sections were the most common at public hospitals (12.6 % in 2009–2011), but C-sections at health centers increased from the second to the third period. The likelihood of having a C-section was associated with living in urban areas and in the southern region, having a formal education and living in a rich household, even adjusting for age and parity (and study periods). The strongest relationship was for the richest household wealth quintile [OR (95 % CI): 9.8 (6.3–15.3)]. The highest rate (20.6 %) was found among the richest women giving birth at public hospitals in the southern region in 2009–2011.
In Mozambique, underuse of C-section was likely among the poor and in rural areas, but overuse in the most advantaged groups seemed to be emerging.
The online version of this article (doi:10.1186/s12884-015-0686-x) contains supplementary material, which is available to authorized users.
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DOI: 10.1186/s12884-015-0686-x
PubMed: 26459290
PubMed Central: 4603730
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Qian Long<affiliation><nlm:aff id="Aff1">Global Health Research Centre, Duke Kunshan University, No. 8 Duke Avenue, 215316 Kunshan City, Jiangsu Province P.R.China</nlm:aff><wicri:noCountry code="subfield">Jiangsu Province P.R.China</wicri:noCountry></affiliation><affiliation wicri:level="1"><nlm:aff id="Aff4">National Institute for Health and Welfare, PO Box 30, FI-00271, Helsinki, Finland</nlm:aff><country xml:lang="fr">Finlande</country><wicri:regionArea>National Institute for Health and Welfare, PO Box 30, FI-00271, Helsinki</wicri:regionArea><wicri:noRegion>Helsinki</wicri:noRegion></affiliation>Le document en format XML
<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Caesarean section rates in Mozambique</title><author><name sortKey="Long, Qian" sort="Long, Qian" uniqKey="Long Q" first="Qian" last="Long">Qian Long</name><affiliation><nlm:aff id="Aff1">Global Health Research Centre, Duke Kunshan University, No. 8 Duke Avenue, 215316 Kunshan City, Jiangsu Province P.R.China</nlm:aff><wicri:noCountry code="subfield">Jiangsu Province P.R.China</wicri:noCountry></affiliation><affiliation wicri:level="1"><nlm:aff id="Aff4">National Institute for Health and Welfare, PO Box 30, FI-00271, Helsinki, Finland</nlm:aff><country xml:lang="fr">Finlande</country><wicri:regionArea>National Institute for Health and Welfare, PO Box 30, FI-00271, Helsinki</wicri:regionArea><wicri:noRegion>Helsinki</wicri:noRegion></affiliation></author><author><name sortKey="Kempas, Taina" sort="Kempas, Taina" uniqKey="Kempas T" first="Taina" last="Kempas">Taina Kempas</name><affiliation wicri:level="1"><nlm:aff id="Aff2">Family Federation of Finland, PO Box 849, FI-00101, Helsinki, Finland</nlm:aff><country xml:lang="fr">Finlande</country><wicri:regionArea>Family Federation of Finland, PO Box 849, FI-00101, Helsinki</wicri:regionArea><wicri:noRegion>Helsinki</wicri:noRegion></affiliation></author><author><name sortKey="Madede, Tavares" sort="Madede, Tavares" uniqKey="Madede T" first="Tavares" last="Madede">Tavares Madede</name><affiliation wicri:level="1"><nlm:aff id="Aff3">Department of Community Health, Eduardo Mondlane University, 702 Salvador Allende Ave, C.P 257, Maputo, Mozambique</nlm:aff><country xml:lang="fr">Mozambique</country><wicri:regionArea>Department of Community Health, Eduardo Mondlane University, 702 Salvador Allende Ave, C.P 257, Maputo</wicri:regionArea><wicri:noRegion>Maputo</wicri:noRegion></affiliation></author><author><name sortKey="Klemetti, Reija" sort="Klemetti, Reija" uniqKey="Klemetti R" first="Reija" last="Klemetti">Reija Klemetti</name><affiliation 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Research Centre, Duke Kunshan University, No. 8 Duke Avenue, 215316 Kunshan City, Jiangsu Province P.R.China</nlm:aff><wicri:noCountry code="subfield">Jiangsu Province P.R.China</wicri:noCountry></affiliation><affiliation wicri:level="1"><nlm:aff id="Aff4">National Institute for Health and Welfare, PO Box 30, FI-00271, Helsinki, Finland</nlm:aff><country xml:lang="fr">Finlande</country><wicri:regionArea>National Institute for Health and Welfare, PO Box 30, FI-00271, Helsinki</wicri:regionArea><wicri:noRegion>Helsinki</wicri:noRegion></affiliation></author><author><name sortKey="Kempas, Taina" sort="Kempas, Taina" uniqKey="Kempas T" first="Taina" last="Kempas">Taina Kempas</name><affiliation wicri:level="1"><nlm:aff id="Aff2">Family Federation of Finland, PO Box 849, FI-00101, Helsinki, Finland</nlm:aff><country xml:lang="fr">Finlande</country><wicri:regionArea>Family Federation of Finland, PO Box 849, FI-00101, Helsinki</wicri:regionArea><wicri:noRegion>Helsinki</wicri:noRegion></affiliation></author><author><name sortKey="Madede, Tavares" sort="Madede, Tavares" uniqKey="Madede T" first="Tavares" last="Madede">Tavares Madede</name><affiliation wicri:level="1"><nlm:aff id="Aff3">Department of Community Health, Eduardo Mondlane University, 702 Salvador Allende Ave, C.P 257, Maputo, Mozambique</nlm:aff><country xml:lang="fr">Mozambique</country><wicri:regionArea>Department of Community Health, Eduardo Mondlane University, 702 Salvador Allende Ave, C.P 257, Maputo</wicri:regionArea><wicri:noRegion>Maputo</wicri:noRegion></affiliation></author><author><name sortKey="Klemetti, Reija" sort="Klemetti, Reija" uniqKey="Klemetti R" first="Reija" last="Klemetti">Reija Klemetti</name><affiliation wicri:level="1"><nlm:aff id="Aff4">National Institute for Health and Welfare, PO Box 30, FI-00271, Helsinki, Finland</nlm:aff><country xml:lang="fr">Finlande</country><wicri:regionArea>National Institute for Health and Welfare, PO Box 30, FI-00271, Helsinki</wicri:regionArea><wicri:noRegion>Helsinki</wicri:noRegion></affiliation></author><author><name sortKey="Hemminki, Elina" sort="Hemminki, Elina" uniqKey="Hemminki E" first="Elina" last="Hemminki">Elina Hemminki</name><affiliation wicri:level="1"><nlm:aff id="Aff4">National Institute for Health and Welfare, PO Box 30, FI-00271, Helsinki, Finland</nlm:aff><country xml:lang="fr">Finlande</country><wicri:regionArea>National Institute for Health and Welfare, PO Box 30, FI-00271, Helsinki</wicri:regionArea><wicri:noRegion>Helsinki</wicri:noRegion></affiliation></author></analytic><series><title level="j">BMC Pregnancy and Childbirth</title><idno type="eISSN">1471-2393</idno><imprint><date when="2015">2015</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background</title><p>The Caesarean section (C-section) rate is used as an indicator for availability and utilization of life-saving obstetric services. The purpose of the present study was to explore changes in C-section rates between 1995 and 2011 by area, place of delivery and maternal socioeconomic factors in Mozambique.</p></sec><sec><title>Methods</title><p>Cross-sectional data from the Demographic and Health Surveys conducted in Mozambique in 1997, 2003 and 2011 were used, including women having a live birth within 3 years prior to the survey. Descriptive statistics and logistic regressions were used to identify factors associated with having a C-section.</p></sec><sec><title>Results</title><p>The C-section rate decreased slightly from 2.5 % in 1995–1997 to 2.1 % in 2001–2003 and then increased to 4.7 % in 2009–2011. In 2009–2011, C-section rates ranged in urban areas from 4.6 % in the northern region to 12.2 % in the southern region and in rural areas from 1.6 % in the northern region to 3.9 % in the southern region. 12.3 % of the richest women had had a C-section, compared to 1.7 % of the poorest women. C-sections were the most common at public hospitals (12.6 % in 2009–2011), but C-sections at health centers increased from the second to the third period. The likelihood of having a C-section was associated with living in urban areas and in the southern region, having a formal education and living in a rich household, even adjusting for age and parity (and study periods). The strongest relationship was for the richest household wealth quintile [OR (95 % CI): 9.8 (6.3–15.3)]. The highest rate (20.6 %) was found among the richest women giving birth at public hospitals in the southern region in 2009–2011.</p></sec><sec><title>Conclusion</title><p>In Mozambique, underuse of C-section was likely among the poor and in rural areas, but overuse in the most advantaged groups seemed to be emerging.</p></sec><sec><title>Electronic supplementary material</title><p>The online version of this article (doi:10.1186/s12884-015-0686-x) contains supplementary material, which is available to authorized users.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Victora, Cg" uniqKey="Victora C">CG Victora</name></author><author><name sortKey="Barros, Aj" uniqKey="Barros A">AJ Barros</name></author><author><name sortKey="Axelson, H" uniqKey="Axelson H">H Axelson</name></author><author><name sortKey="Bhutta, Za" uniqKey="Bhutta Z">ZA Bhutta</name></author><author><name sortKey="Chopra, M" uniqKey="Chopra M">M 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