A national assessment of elective cesarean sections in Bangladesh and the need for health literacy and accessibility

Afiaz, Awan; Arusha, Anowara Rayhan; Ananna, Nurjahan; Kabir, Enamul; Biswas, Raaj Kishore

doi:10.1038/s41598-021-96337-0

Cited by 5 publications

(7 citation statements)

References 61 publications

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“…However, consistent with the present study, recent evidence from Bangladesh has shown that residing in urban areas has no association with c-Sects. [52]. The emerging health literacy about the procedures of c-section deliveries in Bangladesh might explain this.…”

Section: Discussionmentioning

confidence: 99%

Prevalence and predictors of elective and emergency caesarean delivery among reproductive-aged women in Bangladesh: evidence from demographic and health survey, 2017–18

Muhammad

Srivastava

Kumar

et al. 2022

BMC Pregnancy Childbirth

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Background Over the years, an increasing trend of unnecessary caesarean section (c-section) deliveries has raised concerns in Bangladesh. So far, many studies have reported the risk factors of c-section delivery in Bangladesh. However, most of these studies did not estimate the predictors of the two c-section procedures (i.e., emergency and elective) separately based on the timing of the c-section decision. This study solely brings forward the role of socio-demographic and economic factors that may be associated differently with emergency and elective c-section deliveries. Methods Data for the study were drawn from the 2017–18 Bangladesh Demographic and Health Survey with 5,299 women aged 15–49 years who gave birth at a health facility during three years preceding the survey. Descriptive statistics along with bivariate analysis were used to fulfill the study objectives. Further, multivariable logistic regression analysis was conducted on binary outcome variables of elective/emergency c-section deliveries. Results Approximately one-third of women in the reproductive-age group opted for delivery through c-section. Out of them, 18.7% of women had elective c-sections, and 14.1% had emergency c-sections. Women who had mass media exposure were 32% more likely to deliver through elective c-sections than women who had no exposure [AOR: 1.32; CI: 1.02–1.72]. Women with higher education had a 56% lower likelihood of delivering through emergency c-section than women with no educational status [AOR: 0.44; CI: 0.24–0.83]. Children from the third or higher birth order were significantly more likely to be delivered through elective c-sections than those from the first birth order [AOR: 2.67; CI: 1.75–4.05]. In contrast, children with higher birth order had fewer chances of emergency c-section than children with first birth order [AOR: 0.29; CI: 0.18 -0.45]. Both elective and emergency c-section deliveries were significantly higher among private health facilities. Conclusion Although c-section delivery has emerged as a life-saving intervention, the overuse of such practice has created lucrative risks for the mother and unborn child. Proper sensitization of mothers and families can enhance the knowledge of the unsafe nature of unnecessary c-section deliveries. Authorizations in case of over-use of elective and emergency c-sections should be observed to minimize the unnecessary c-sections and related complications and to increase normal institutional deliveries in Bangladesh.

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Section: Discussionmentioning

confidence: 99%

Prevalence and predictors of elective and emergency caesarean delivery among reproductive-aged women in Bangladesh: evidence from demographic and health survey, 2017–18

Muhammad

Srivastava

Kumar

et al. 2022

BMC Pregnancy Childbirth

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“…Choosing the mode of delivery appears to be influenced by health literacy. A study in Bangladesh showed that health awareness, health education, and better health communication via mass media foster mothers' ability to access appropriate health care advice on options for a safe birth and other related issues [22].…”

Section: Discussionmentioning

confidence: 99%

Cesarean delivery in Iran: a population-based analysis using the Robson classification system

Pourshirazi

Heidarzadeh

Taheri

et al. 2022

BMC Pregnancy Childbirth

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Background The rise of Cesarean Sections (CS) is a global concern. In Iran, the rate of CS increased from 40.7% in 2005 to 53% in 2014. This figure is even higher in the private sector. Objective To analyze the CS rates in the last 2 years using the Robson Classification System in Iran. Methods A retrospective analysis of all in-hospital electronically recorded deliveries in Iran was conducted using the Robson classification. Comparisons were made in terms of the type of hospital, CS rate, and obstetric population, and contributions of each group to the overall cesarean deliveries were reported. Results Two million three hundred twenty-two thousand five hundred women gave birth, 53.6% delivered through CS. Robson group 5 was the largest contributing group to the overall number of cesarean deliveries (47.1%) at a CS rate of 98.4%. Group 2 and 1 ranked the second and third largest contributing groups to overall CSs (20.6 and 10.8%, respectively). The latter groups had CS rates much higher than the WHO recommendation of 67.2 and 33.1%, respectively. “Fetal Distress” and “Undefined Indications” were the most common reasons for cesarean deliveries at CS rates of 13.6 and 13.4%, respectively. There was a significant variation in CS rate among the three types of hospitals for Robson groups 1, 2, 3, 4, and 10. Conclusion The study revealed significant variations in CS rate by hospital peer-group, especially for the private maternity units, suggesting the need for further attention and audit of the Robson groups that significantly influence the overall CS rate. The study results will help policymakers identify effective strategies to reduce the CS rate in Iran, providing appropriate benchmarking to compare obstetric care with other countries that have better maternal and perinatal outcomes.

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“…Ahmed, Khoja and Tirmizi [ 26 ] reported that strict religious norms hinder mothers’ access to antenatal care. Furthermore, male dominance in a factor in societies such as Bangladesh and Pakistan, which may have played a role in care for mothers and seeking appropriate medical services [ 27 , 28 , 29 ].…”

Section: Discussionmentioning

confidence: 99%

Factors Associated with Low Birthweight in Low-and-Middle Income Countries in South Asia

Ngo

Bhowmik

Biswas

2022

IJERPH

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Child with Low Birth Weight (LBW) has a higher risk of infant mortality, learning difficulties in childhood due to stunted growth and impaired neurodevelopment, is more likely to develop heart diseases and diabetes in adulthood. This study aimed to evaluate the latest demographic and health surveys (DHSs) across multiple countries in South Asia to determine the factors associated with LBW among these countries. Latest available DHS data across Afghanistan (2015, n = 29,461), Bangladesh (2018, n = 20,127), Nepal (2016, n = 12,862), and Pakistan (2018, n = 15,068) were analysed. Complex survey adjusted generalized linear models were fitted to investigate the association of birth weight with sociodemographic and decision-making factors. Pakistan had the highest proportion of LBW at 18% followed by Afghanistan and Bangladesh at around 14% and Nepal had the lowest (13%). Children born in Pakistan were more likely to have LBW children than Afghanistan (AOR = 2.17, 95% CI = 1.49–3.14). Mothers living in rural areas (AOR = 0.77, 95% CI = 0.61–0.97), with highly educated partners and belonging to richer families were less susceptible to having child with LBW. To reduce 30% LBW in-line with the World Health Organisation’s 2025 goal, policymakers in SA should focus on women in urban areas with low-educated partners belonging to poor households to ease LBW burden.

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A national assessment of elective cesarean sections in Bangladesh and the need for health literacy and accessibility

Cited by 5 publications

References 61 publications

Prevalence and predictors of elective and emergency caesarean delivery among reproductive-aged women in Bangladesh: evidence from demographic and health survey, 2017–18

Prevalence and predictors of elective and emergency caesarean delivery among reproductive-aged women in Bangladesh: evidence from demographic and health survey, 2017–18

Cesarean delivery in Iran: a population-based analysis using the Robson classification system

Factors Associated with Low Birthweight in Low-and-Middle Income Countries in South Asia

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