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
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<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 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></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">26459290</idno><idno type="pmc">4603730</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4603730</idno><idno type="RBID">PMC:4603730</idno><idno type="doi">10.1186/s12884-015-0686-x</idno><date when="2015">2015</date><idno type="wicri:Area/Pmc/Corpus">000679</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000679</idno><idno type="wicri:Area/Pmc/Curation">000678</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">000678</idno><idno type="wicri:Area/Pmc/Checkpoint">000E69</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Checkpoint">000E69</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">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 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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<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></journal-title-group><issn pub-type="epub">1471-2393</issn><publisher><publisher-name>BioMed Central</publisher-name><publisher-loc>London</publisher-loc></publisher></journal-meta><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>Pour manipuler ce document sous Unix (Dilib)
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