Prevalence of Caesarean section and the Associated Factors in Private Hospitals in Addis Ababa - a Cross-Sectional Study
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Date
2017-06
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Addis Abeba Universty
Abstract
Background: Caesarean delivery has been increasing at an alarming rate globally. This increase
has become a major challenge across health institutions in both developed and developing
countries. Caesarean delivery rate has been shown to be more common in the private fee–for–
service hospitals than public hospitals. The Ethiopia Demographic and health survey reported an
increase in the caesarean delivery rate between 2005 and 2011 from 16% to 21.8% and even a
higher rate among women who delivered in private health institutions (41.7%) which was twice
higher than their counterparts who delivered in public institutions (20.6%) signifying the
possibility of over-utilization of the service in the private hospital.
Objective: To determine the prevalence of Caesarean delivery and the associated factors in
private hospital in Addis Ababa.
Method: This study was a facility based cross-sectional survey carried out in private hospitals in
Addis Ababa during the months of April to May 2017. Study participants were selected using
multi-stage random sampling technique. Four hundred and eleven consecutive delivered mothers
who consented from the selected private hospitals providing basic and comprehensive obstetrics
services participated in study. A pre-tested structured questionnaire was used to obtain
information from the respondents. Data was entered in Epi Info version 7 and exported to
STATA version 12 for analysis. Multivariable analysis was carried out. Strength of associations
and significance level was examined using odds ratio and 95% confidence intervals respectively.
Result: The prevalence of Caesarean delivery in private hospitals in Addis Ababa was 63.7% [CI
(59.1%, 68.3%)]. Being primiparous [AOR=2.89, 95% CI (1.19, 6.98)], multiparous
[AOR=10.2, 95% CI (4.13, 25.4)], previous Caesarean delivery [AOR=12.48, 95% CI (6.01,
25.95)] and having health insurance coverage were found to be positive and statistically
significantly associated with having Caesarean delivery.
Conclusion: Limiting primary Caesarean delivery to the barest minimum by only performing
such for only absolute indications, allowing vaginal birth after Caesarean section (VBAC)
through close monitoring during labour, counselling of parturient at the antenatal clinics on
possibility of VBAC and the risks associated with unnecessary request for Caesarean section
would be important to decrease the high prevalence of CS.
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Keywords
Prevalence of Caesarean section and the Associated Factors