Cesarean Section Delivery Prevalence and Associated Factors among Private and Public Hospitals in Addis Ababa
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Date
2020-12
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Addis Abeba University
Abstract
Background
Caesarean section is a surgical technique in which a baby is brought through incisions made in the
mother’s abdomen. Caesarean section as a proportion of all births is used as an Emergency Obstetric
Care indicator because it is a degree of use and access to a common obstetric intervention that avert
maternal and neonatal deaths as well as preventing problems, such as obstetric fistulae. According to a
2007 analysis expected a global caesarean section rate of 15% and there was great regional difference:
the lowest caesarean section rates were seen in Africa (3.5%) while the highest were in Latin America
(29.2%).
Objective
This study was aimed to assess the prevalence, indications and factors affecting cesarean section
delivery among mothers who gave birth in public and private health facilities of Addis Ababa from
August,2019 to October ,2019.
Methods
cross sectional study was conducted to assess the prevalence of cesarean section delivery, indications
and associated factors in selected private and public hospitals in Addis Ababa. Using simple random
sampling method two hospitals from the public and four from private hospitals were selected. Using
systematic random sampling method 642 mothers who gave birth in the selected hospitals were included
in the study. Data was entered in to SPSS version 20 then data cleaning was done. Descriptive statistics
were used for frequency and percentage, binary and multivariable logistic regressions was done to see
relationship (associations) of the dependent variable with multiple factors. OR together with 95% CI and
P-value <0.05 was used to measure statistical significance. The result is summited to Addis Ababa
university school of public health, Addis Ababa health office and for those hospitals where the study
was conducted.
Results
The study discovered that the prevalence of cesarean section in public hospitals was 46.7% and 72.3% in
private hospitals in Addis Ababa. 31.8 % of cesarean section deliveries in private hospital were not
performed due to maternal or fetal conditions(elective). Cesarean section delivery was significantly
associated with: age of respondents [AOR of 0.26 0.89,0.57)95 % CI], partner work condition [AOR
=0.44 (0.26,0.76) 95%CI]. Economic status [AOR=5.02(1.21,20.70) 95%CI], operational history [AOR
= 25.39(13.972.46.15)95 % CI], pregnancy history [ AOR = 2.61(1.63,4.16) 95 % CI] and facility type
[AOR =0.29(0.17,0.50) 95% CI]. Regarding to indications of CS, 96.1% of CS performed in public
hospitals has been based on mother and fetal condition and about 3.9% was based on mothers’ interest.
In contrast, only 68.1% of CS delivery performed in private hospitals was based on indications
recognized from mother and fetal condition.
Conclusions
The proportion of CS delivery was higher than the recommended one in both government and private
hospitals. Delivering at government hospital was found to be more protective than private hospital for
cesarean section delivery. Age of respondents, Partner work condition, economic status of respondents,
history of previous operations, pregnancy history (multigravida) and facility type were factors
significantly associated with cesarean section delivery.
Description
Keywords
Cesarean section delivery