Does Timing of Antenatal Care Initiation and the Contents of Care Have Effect on Caesarean Delivery in Ethiopia? Findings from Demographic and Health Survey

Abstract

Background. Antenatal care (ANC) is an important preventive set of core healthcare services through pregnancy. Caesarean deliveries are significantly increasing in many low-, middle-, and high-income countries. However, overuse of the caesarean section service interferes with the quality and cost of the procedure. Hence, this study aimed to assess the effect of timing of first antenatal care initiation and the contents of care on caesarean delivery. Methods. A population level cross-sectional study was conducted with a total of 4757 study participants. The multivariable analysis was computed using the setup of 3 models. Results. The rate of caesarean section among women who initiated antenatal care in the first trimester was 1.32% (95% CI = 0.91–4.21). Women initiated antenatal care in the first trimester (AOR = 2.74; 95% CI = 1.49–6.2) and received contents of care (AOR = 1.98; 95% CI = 1.24–3.78])were more likely to have caesarean section delivery as compared to their counterparts. Conclusion. Caesarean section among women who initiated ANC in the first trimester is low. The finding suggests ANC initiated early (within 16 weeks) can have a positive impact on caesarean section delivery. In addition, being urban residents, primipara women, initiating antenatal care before 16 weeks, received contents of care, and having antenatal care visits three and more increase the odds of having caesarean section. As a result, different obstetric, medical, and surgical complications are detected and managed as early as possible.

Alarming Trends of Cesarean Section—Time to Rethink: Evidence From a Large-Scale Cross-sectional Sample Survey in India

“…Similarly, better access to health services promotes CS. This is evident from an increase in the likelihood of CS births with the increase in the number of ANC visits or early initiation of ANC checkups [ 36 , 37 ], similar to our study.…”

Low-Value Surgical Procedures in Low- and Middle-Income Countries

“…The 133 included studies collectively reported on more than 9.1 million surgical procedures (median per study, 894 [IQR, 97-4259]) and more than 11.4 million participants (median per study, 989 [IQR, 257-6857]) from 63 LMICs . Of all 133 LMICs, we found studies from 15 of all 29 low-income countries (51.7%), 25 of all 50 lower-middle–income countries (50.0%), and 23 of all 55 upper-middle–income countries (41.8%) . Fourteen studies (10.5%) were multinational …”

“…Most studies (115 [86.5%]) were published in 2010 or after, with a marked increase in the number of included studies per year. Most articles were written in English (126 [94.7%]) . Health care settings were hospital based or secondary care in 93 studies (69.9%) …”

“…Most articles were written in English (126 [94.7%]) . Health care settings were hospital based or secondary care in 93 studies (69.9%) . Of the 133 included studies, 107 (80.5%) were observational…”

“…43, 45-48, 53, 57, 59, 63, 66, 67, 69, 71, 72, 77-80, 82, 83, 86, 92, 93, 95, 99-102, 106, 109, 112-114, 116-118, 122-124, 127-130, 134-137, 140, 144-150, 156, 157, 159, 162, 164 A total of 14 studies (23.3%) reported on individual-level factors (ie, clinician or patient)45,46,48,59,66,72,82,93,99,124,134,157,159,162 ; 18 (30.0%), system-level factors (ie, institutional or organizational)71,83,86,92,100,101,113,114,116,117,127,128,130,135,145,148,156,164 ; and 28 (46.7%), both individual-and system-level factors43, 47, 53, 57, 63, 67, 69, 77-80, 95, 102, 106, 109, 112, 118, 122, 123, 129, 136, 137, 140, 144, 146, 147, 149, 150 (Table …”