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.
Url:
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>
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<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>
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