Caesarean section rates in Mozambique
Identifieur interne : 000E69 ( Pmc/Checkpoint ); précédent : 000E68; suivant : 000E70Caesarean 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
Affiliations:
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PMC:4603730Le document en format XML
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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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<front><journal-meta><journal-id journal-id-type="nlm-ta">BMC Pregnancy Childbirth</journal-id>
<journal-id journal-id-type="iso-abbrev">BMC Pregnancy Childbirth</journal-id>
<journal-title-group><journal-title>BMC Pregnancy and Childbirth</journal-title>
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<issn pub-type="epub">1471-2393</issn>
<publisher><publisher-name>BioMed Central</publisher-name>
<publisher-loc>London</publisher-loc>
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<article-meta><article-id pub-id-type="pmid">26459290</article-id>
<article-id pub-id-type="pmc">4603730</article-id>
<article-id pub-id-type="publisher-id">686</article-id>
<article-id pub-id-type="doi">10.1186/s12884-015-0686-x</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject>
</subj-group>
</article-categories>
<title-group><article-title>Caesarean section rates in Mozambique</article-title>
</title-group>
<contrib-group><contrib contrib-type="author" corresp="yes"><name><surname>Long</surname>
<given-names>Qian</given-names>
</name>
<address><email>qian.long@dku.edu.cn</email>
</address>
<xref ref-type="aff" rid="Aff1"></xref>
<xref ref-type="aff" rid="Aff4"></xref>
</contrib>
<contrib contrib-type="author"><name><surname>Kempas</surname>
<given-names>Taina</given-names>
</name>
<address><email>tainakempas@hotmail.com</email>
</address>
<xref ref-type="aff" rid="Aff2"></xref>
</contrib>
<contrib contrib-type="author"><name><surname>Madede</surname>
<given-names>Tavares</given-names>
</name>
<address><email>tmadede@gmail.com</email>
</address>
<xref ref-type="aff" rid="Aff3"></xref>
</contrib>
<contrib contrib-type="author"><name><surname>Klemetti</surname>
<given-names>Reija</given-names>
</name>
<address><email>reija.klemetti@thl.fi</email>
</address>
<xref ref-type="aff" rid="Aff4"></xref>
</contrib>
<contrib contrib-type="author"><name><surname>Hemminki</surname>
<given-names>Elina</given-names>
</name>
<address><email>elina.hemminki@thl.fi</email>
</address>
<xref ref-type="aff" rid="Aff4"></xref>
</contrib>
<aff id="Aff1"><label></label>
Global Health Research Centre, Duke Kunshan University, No. 8 Duke Avenue, 215316 Kunshan City, Jiangsu Province P.R.China</aff>
<aff id="Aff2"><label></label>
Family Federation of Finland, PO Box 849, FI-00101, Helsinki, Finland</aff>
<aff id="Aff3"><label></label>
Department of Community Health, Eduardo Mondlane University, 702 Salvador Allende Ave, C.P 257, Maputo, Mozambique</aff>
<aff id="Aff4"><label></label>
National Institute for Health and Welfare, PO Box 30, FI-00271, Helsinki, Finland</aff>
</contrib-group>
<pub-date pub-type="epub"><day>12</day>
<month>10</month>
<year>2015</year>
</pub-date>
<pub-date pub-type="pmc-release"><day>12</day>
<month>10</month>
<year>2015</year>
</pub-date>
<pub-date pub-type="collection"><year>2015</year>
</pub-date>
<volume>15</volume>
<elocation-id>253</elocation-id>
<history><date date-type="received"><day>26</day>
<month>2</month>
<year>2015</year>
</date>
<date date-type="accepted"><day>4</day>
<month>10</month>
<year>2015</year>
</date>
</history>
<permissions><copyright-statement>© Long et al. 2015</copyright-statement>
<license license-type="OpenAccess"><license-p><bold>Open Access</bold>
This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by/4.0/">http://creativecommons.org/licenses/by/4.0/</ext-link>
), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/publicdomain/zero/1.0/">http://creativecommons.org/publicdomain/zero/1.0/</ext-link>
) applies to the data made available in this article, unless otherwise stated.</license-p>
</license>
</permissions>
<abstract id="Abs1"><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>
</abstract>
<kwd-group xml:lang="en"><title>Keywords</title>
<kwd>Caesarean section rate</kwd>
<kwd>Underuse</kwd>
<kwd>Overuse</kwd>
<kwd>Health system research</kwd>
<kwd>Mozambique</kwd>
</kwd-group>
<custom-meta-group><custom-meta><meta-name>issue-copyright-statement</meta-name>
<meta-value>© The Author(s) 2015</meta-value>
</custom-meta>
</custom-meta-group>
</article-meta>
</front>
</pmc>
<affiliations><list><country><li>Finlande</li>
<li>Mozambique</li>
</country>
</list>
<tree><country name="Finlande"><noRegion><name sortKey="Long, Qian" sort="Long, Qian" uniqKey="Long Q" first="Qian" last="Long">Qian Long</name>
</noRegion>
<name sortKey="Hemminki, Elina" sort="Hemminki, Elina" uniqKey="Hemminki E" first="Elina" last="Hemminki">Elina Hemminki</name>
<name sortKey="Kempas, Taina" sort="Kempas, Taina" uniqKey="Kempas T" first="Taina" last="Kempas">Taina Kempas</name>
<name sortKey="Klemetti, Reija" sort="Klemetti, Reija" uniqKey="Klemetti R" first="Reija" last="Klemetti">Reija Klemetti</name>
</country>
<country name="Mozambique"><noRegion><name sortKey="Madede, Tavares" sort="Madede, Tavares" uniqKey="Madede T" first="Tavares" last="Madede">Tavares Madede</name>
</noRegion>
</country>
</tree>
</affiliations>
</record>
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