Prevalence and determinants of the use of caesarean section (CS) in the dichotomy of ‘public’ and ‘private’ health facilities in West Bengal. India

Abstract

ObjectiveDespite of long-term inverse consequences of caesarean delivery, the incidence is rising high in many states in India including West Bengal. The paper examines socio-demographic correlates of cesarean delivery and post-delivery complications and care among women in West Bengal. MethodsUsing a sample of 5328 live births born within the last five years of the survey to the 4459 women in West Bengal obtained from the National Family and Health Survey (NFHS-4), the study estimates cesarean delivery rates and average delivery costs separately for private and public hospitals. Descriptive bivariate statistics and logistic-model were used to examine differentials and determinants for C-Section delivery. ResultsAlmost 24% livebirths born within the last five-years preceding the survey reported as cesarean delivery. The cesarean delivery rate is alarmingly high in private hospitals (71%) compared to public hospitals (19%). Nearly 55% of total cesarean delivery was contributed by private hospitals only. The multivariate analysis shows that the mother's level of education, mother's BMI, and household economic conditions have shown a significant positive association with the higher prevalence of caesarean delivery. ConclusionCaesarean delivery became a primary mode of delivery without any medical consideration especially in private hospitals in West Bengal. These unnecessary deliveries need to be cheeked in priority for safe motherhood and wellbeing of mother and child.