Abstract
The study aimed to assess and compare the prevalence of caesarean birth and associated factors among women gave birth at public and private health facilities in Bahir Dar city, Amhara region, Ethiopia. An institution-based comparative cross-sectional study design was conducted from March1-April 15, 2019 at health facility provide emergency obstetrics service in Bahir Dar city. Study participants 724(362 for each public and private facility) were recruited using a systematic random sampling technique. Structured interview administered questionnaires and chart review checklist were used to collect data. The data were entered into Epi info version 7.2 and analyzed using SPSS version 23.0 software. A binary logistic regression model was fitted and an adjusted odds ration with 95% CI was used to determine the presence and strength of association between independent variables and cesarean birth. The response rate was 98.3% and 97.2% for public and private health facilities respectively. The prevalence of caesarean birth in private health facilities was 198 (56.3%) (95%CI: 50.9, 61.4) and in public health facilities was 98 (27.5%) (95%CI: 22.8, 32.2). Overall prevalence of caesarean birth was 296 (41.8%) (95%CI: 38.4, 45.5). Breech presentation (AOR = 3.64; 95%CI:1.49, 8.89), urban residence (AOR = 6.54; 95%CI:2.59, 16.48) and being referred (AOR = 2.44; 95%CI:1.46, 4.08) were variables significantly associated with caesarean birth among public facilities whereas age between 15-24 (AOR = 0.20, 95% CI; 0.07, 0.52), government employe (AOR = 2.28; 95%CI: 1.39,3.75), self-employed (AOR = 3.73; 95%CI:1.15,8.59), para one (AOR = 6.79; 95%CI:2.02, 22.79), para two (AOR = 3.88; 95% CI:1.15,13.08), and wealth index being highest level of wealth asset AOR = 5.39; 95%CI:1.08, 26.8) in private health facility associated with caesarean birth. We concluded that there is high prevalence of caesarean birth both in private and public facility. There is a statistically significant difference in the prevalence of caesarean birth in public and private health facilities.
Highlights
Caesarean section (CS) is an operative technique by which a fetus is delivered through an abdominal and uterine incision of the mother[1]
Breech presentation (AOR = 3.64; 95%confidence interval (CI):1.49, 8.89), urban residence (AOR = 6.54; 95%CI:2.59, 16.48) and being referred (AOR = 2.44; 95%CI:1.46, 4.08) were variables significantly associated with caesarean birth among public facilities whereas age between 15–24 (AOR = 0.20, 95% CI; 0.07, 0.52), government employe (AOR = 2.28; 95%CI: 1.39,3.75), self-employed (AOR = 3.73; 95% CI:1.15,8.59), para one (AOR = 6.79; 95%CI:2.02, 22.79), para two
High prevalence of caesarean birth among mothers delivered at health facilities in Bahir Dar city
Summary
Caesarean section (CS) is an operative technique by which a fetus is delivered through an abdominal and uterine incision of the mother[1]. When adequately indicated caesarean section is one of the life-saving procedures that attributed to the decrease of the maternal and neonatal mortality and morbidity rates globally [2].Cesarean section was first major operation for high-risk pregnancy. The safety of the operation has improved with time, largely due to improved surgical and anesthetic techniques[4]. World Health Organization (WHO) suggested that the rates of the caesarean section should not exceed 15% because has no additional benefit for the newborns or the mothers. WHO released a statement indicating that at the population level, rates higher than 10% were not associated with reductions in maternal and newborn mortality rates in developing countries[6]
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