Trends of caesarean section deliveries in Pakistan: secondary data analysis from Demographic and Health Surveys, 1990-2018 (original) (raw)
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BMC pregnancy and childbirth, 2018
The increasing rate of caesarean deliveries has become a serious concern for public health experts globally. Various medical and non-medical factors, such as maternal socio-demographics, are found to be responsible for this upsurge. Like in other countries, the rate of caesarean sections has increased in Pakistan as well. Therefore, there is a need to investigate the factors behind this increase. This study aims to assess the determinants associated with caesarean deliveries among child-bearing women aged 15-49 years in Pakistan. Secondary data analysis was conducted on nationally representative cross-sectional survey data from the Pakistan Demographic and Health Survey, 2012-2013. The analysis was limited to mothers aged 15-49 years, who had given birth to at least one child during the 5 years immediately preceding the survey (n = 7461). Maternal socio-demographic characteristics and pregnancy-related variables, including antenatal care utilisation, place of delivery and pregnancy ...
Prevalence and determinants of Caesarean delivery in Punjab, Pakistan
Eastern Mediterranean Health Journal, 2018
especially in developing countries (5). As a reference, the World Health Organization, in its 1985 report, suggested an optimal range for C-section rates of 5-15% (6). Many studies have found that the likelihood of delivery through C-section depends on a number of institutional, demographic and socioeconomic factors. The availability of facilities, obstetricians and the place of birth, that is, private or public sector institutions, is associated with C-section rate (7,8). C-section is significantly associated with multiple conception, maternal age at birth, rise in institutional deliveries, number of previous deliveries, site of prenatal care (private or public), socioeconomic status of household and access to antenatal care (9-11). Some maternal characteristics such as education and access to antenatal care are also strongly associated with the likelihood of C-section (4,10,12). In view of the recent understanding about the factors associated with C-section, this study identified a set of socioeconomic, demographic, spatial and institutional indicators associated with C-section delivery. We used data from the Multiple Indicator Cluster Survey (MICS)
PLOS ONE, 2017
Despite global efforts to improve maternal health, many developing countries including Pakistan have failed to achieve the target of a 75% reduction in maternal deaths by 2015. Addressing socioeconomic inequalities in access to emergency obstetric care is crucial for reducing the maternal mortality rate. This study was done to examine the time trends and socioeconomic inequalities in the utilization of cesarean section (C-section) in Pakistan during 1990-2013. We used data from the Pakistan Demographic and Health Surveys (PDHS) conducted during 1990 to 2013. All these surveys are nationally representative surveys of ever-married women aged 15-49 years with a sample size
The Factors Influencing Cesarean - Section Rates - A Narrative Review from Pakistan
The Journal of medical research, 2021
The significant increase in the rate of cesarean section is a major public health issue. The World Health Organization recommends C-section rates not to be greater than 10% and not lower than 5% as both the indicated limits can adversely affect maternal and newborn health. The rate of C-section deliveries is 22% according to recent Pakistan demographics and Health Survey of 2017-2018. This study contributes to the existing literature by examining the factors influencing high C-section rates in Pakistan. A narrative review of published literature between 2000 to 2020, on "factors influencing C-section rates in Pakistan" was done. The findings highlighted five factors that primarily influence utilization of C-section which include: 1. Accessibility to utilize C-section, 2. Association of C-section rates with socioeconomic profile, 3. Elective C-section, 4. Medical conditions as a cause of C-section, 5. C-section as a source of business. Pakistan like other Low middle income countries (LMICs) is facing the increased disease burden on its week and fragile health system. The over utilization of C-section rates has imposed additional burden on the health care system of Pakistan as well as increased economic and health resource liability on maternal care.
The Journal of medical research, 2021
Background: Caesarean section was one of the major issues in worldwide both in developed and developing countries. In Punjab, high prevalence of C-section had been perceived. Objective: To assess the prevalence, socio-demographic and socioeconomic factors of caesarean section in the Punjab. Methodology: The study was based on the data of Multiple Indicators Cluster Survey 2017-18 (MICS Punjab). Two-stage, stratified cluster sampling technique was adopted. Almost 53,840 households were selected to obtain the data from Punjab. Target population was currently and ever married women (15,656) who have given birth in last two years. From these women, a question was asked whether the delivery was normal or by C-section. We gave value 1 if delivered by C-section and 2 otherwise by using the Statistical Package for Social Sciences (SPSS) version 23. Results: The prevalence of C-section was 28.9% in the Punjab with 95% C.I (28.9%, 29.7%) and odds ratio (OR) 3.13. Out of ten, three women delivered baby by C-section. Area of residence, number of antenatal care visits, mother's age at time of marriage, education, wealth index quintile, and tetanus toxoid injection during last pregnancy were highly associated with the C-section. Educated and rich women were more attracted to deliver by C-section as compare to a women who were uneducated and belonged to poor socioeconomic group. In Central Punjab higher cases were found as compare to the South Punjab and Northern Punjab. Conclusion: The prevalence of C-sections is very high in Punjab when compared with WHO standard. The contributing factors to this rising trend of increased rate of C-section, higher education, improvement of socioeconomic status and easy accessibility of C-section facilities.
International Journal of Environmental Research and Public Health, 2021
The increasing frequency of cesarean section (CS) is a major public health issue, and it is on the rise in Pakistan. A cross-sectional study approach was used to assess the frequency of CS and its contributing factors, along with the assessment of knowledge in mothers who had undergone CS in one of the under-developed regions of Pakistan. Data collection was done by using a self-developed study questionnaire. The statistical package for social sciences (SPSS) was utilized for the statistical analysis. During the study period, a total of 173 (69.7%) women have given births by CS; among those, 104 (60.1%) were elective/planned CSs while 69 (39.8%) were emergency CSs. The higher CS frequency was significantly associated with younger age (p = 0.03) and pre-term gestational age (p < 0.001). Pregnancy complications, such as gestational diabetes, hypertension, preeclampsia/eclampsia, and vaginal bleeding, were the significant risk factors for CS (p < 0.001). The highlighted contribut...
International Health, 2022
Background Caesarean delivery has a significant role in reducing maternal and child death. However, unnecessary utilization has adverse health effects. This study aimed to assess the prevalence and associated factors of caesarean delivery in Bangladesh. Methods Data from the latest Bangladesh Multiple Indicator Cluster Survey (MICS, 2019) was used in this study. Since MICS data are hierarchical in nature, multilevel modelling was used. Results The prevalence of caesarean section (CS) was 67.4% among Bangladeshi women. Multilevel analysis suggests the age of the women, household wealth status, utilization of antenatal care (ANC) , delivery at a health facility and division were significantly associated with CS. Women who delivered in a private health facility had the highest odds for CS (odds ratio [OR] 10.35 [95% confidence interval {CI} 8.55 to 12.54]). Women 30–34 y of age had a 36% higher likelihood of CS compared with women 15–19 y of age (OR 1.36 [95% CI 1.03 to 1.79]). The odd...
BMC Pregnancy and Childbirth
Background Caesarean section (CS) delivery has a significant effect on maternal and neonatal health especially in a developing country like Bangladesh. The aim of the study was to determine the risk factors and their individual contribution to CS delivery among Bangladeshi married women in reproductive age. Methods The cross sectional secondary data was used in this study. Data was extracted from Bangladesh Demographic and Health Survey (BDHS), 2014 dataset. BDHS-2014 collected data from all over Bangladesh. Stepwise logistic regression analysis and population attributable fractions (PAF) were utilized in this study. Results A total number of 4422 married Bangladeshi women having at least one child (age ≤ 5 years) were considered in this study. The prevalence of CS delivery among Bangladeshi women was 23.94%. The stepwise logistic regression model showed that location (division), type of residence, education of respondent and her husband, working status, age at first birth, number o...
Correlates of Caesarean Section Delivery in West Bengal, India: An Analysis Based on DLHS-3
Intechopen, 2019
It has been well recognised that medically unnecessary caesarean section (C-section) delivery could increase morbidity risks for both the mother and her child and also could put strain on both institutional and individual assets mainly in developing countries. The present study tried to assess the variations in C-section delivery rates by women's background characteristics and to examine the factors associated with C-section delivery in West Bengal-a state of India. Data from the third round of the District Level Household and Facility Survey (DLHS-3) 2007-2008, covering 6447 ever-married women of age 15-49 years, were used. The results reveal that about 12% women delivered their babies by C-section irrespective of place of delivery, but it rose to about 24% in only institutional delivery. It is also found that the rate of C-section delivery was excessively high in private health facilities (55.8%) followed by higher educated women (50.4%) and for health insurance (36.4%), and antenatal care service eight or more times (36%). The results of predicted (adjusted) probability computed from logistic regression reveal that delivery in private health facilities, higher maternal age, lower birth order and higher level of education were the main influential factors of C-section delivery.
2021
BackgroundCaesarean section (CS) use is on the rise in Bangladesh, particularly among women in improved socio-economic condition. However, the deficit use of CS remains common among disadvantage women in terms of employment, education, wealth quintile, and place of residence. This increases risks of long-term obstetric complications as well as maternal and child deaths. We aimed to determine the interaction effects of women’s disadvantage characteristics on CS use in Bangladesh.MethodsTotal of 27,093 women data analysed extracted from five rounds of Bangladesh Demographic and Health Survey, conducted between 2004 and 2017/18. The inclusion criteria used to select these women were: (i) having at least one child within three prior to the survey, (ii) reported delivery methods and place, and (iii) do not have twin or more ordered pregnancy for the most recent live birth. The major exposure variables were type of health facilities, divisions, place of residence, economic status, and mat...