Time Series Analysis and Forecasting of Caesarian Section Births in Ghana

Bosson-Amedenu Senyefia

doi:10.11648/j.bsi.20190401.11

Abstract

Caesarian Section (CS) rates have been known to have geographical varaitions. The purpose of this paper was to determine Ghana’s situation (regional trend) and also to provide a two- year forcast estimates for the ten (10) regions of Ghana. The data was longitudinal and comprised monthly CS records of women from 2008 to 2017. The dataset was divided into training and testing dataset. A total of eighty four (84) months were used as the training dataset and the remaining thirty six (36) months were used as testing dataset. The ARIMA methodology was applied in the analysis. Augmented Dicker-Fuller (ADF), KPSS and the Philips-Perron (PP) unit root tests were employed to test for stationarity of the series plot. KPSS (which is known to give more robust results) and PP test consistently showed that the series was stationary (p ＜ 0.05) for all ten (10) regions, although there were some conflicting results with the ADF test for some regions. Tentative models were formulated for each region and the model with the lowest AIC was selected as the “Best” model fit for respective regions of Ghana. The “best” Model fit for Greater Accra, Central and Eastern regions were respectively SARIMA (2, 0, 0) (0, 1, 1)12, SARIMA (2, 0, 0) (0, 1, 1)12 with a Drift and SARIMA (1, 1, 1) (0, 1, 1)12. Additionally, the best model fit for Northern and Volta regions were SARIMA (3,0,2) (0,1,1)12 with drift and SARIMA (0,1,1) (0,1,1)12. Ashanti, Upper East and Western regions failed the JB test or the normality test for the residuals. Upper West and Brong Ahafo Regions were not suitable for forecasting due failure to depict white noise and ARCH test failure, respectively. The best models fit were used to forecast for 2019 and 2020. The results showed that regional variations of CS exist in Ghana. The study recommended for future studies to apply methods that will allow for forecasting for regions which failed the test under the methods used in this study.

Highlights

The main conditions which may warrant the use of Ceasarian Section (CS) method of delivery include previous CS, breech presentation, fetal distress, dystocia and multiple pregnancy
The seasonal pattern for Eastern peaked in January, Greater Accra peaked in May Ashanti peaked in both May and October
Among the formulated statistical models (Table 2), SARIMA (2,0,0) (0,1,1)12 with Drift was selected as the best model with AIC value of 777.57, mean percent error of 1.93 and p-value (LJung-Box test) of 0.99 for the Central region

Summary

Introduction

The main conditions which may warrant the use of Ceasarian Section (CS) method of delivery include previous CS, breech presentation, fetal distress, dystocia and multiple pregnancy. Contemporary CS rates make it obvious that there are other factors other than the strict medical need that influence the decision to use CS method. This increasing trend has motivated research in the area to identify workable interventions to control its excessive abuse. Postpartum pain is common among women who deliver babies either by vaginal or ceasarian modes, it has been reported in many studies that postpartum pain is rampantly observed within an extended period of time among women who have undergone ceasarian birth delivery [1, 2]. Th likelyhood of CS is known to be directly proportional to mother’s age and inversely proportional to parity [5]

Objectives

Methods

Results

Conclusion