Prevalence and associated factors of caesarian section in Ethiopia: a multilevel analysis of the 2019 Ethiopia Mini Demographic Health Survey

Abstract

Background Caesarian section is a vital emergency obstetric intervention for saving the lives of mothers and newborns. However, factors which are responsible for caesarian section (CS) were not well established in the country level data. Therefore, this study aimed to assess the prevalence and associated factors of caesarian section in Ethiopia. Methods Data from the Ethiopian Mini Demographic and Health survey 2019 were used to identify factors associated with the caesarian section in Ethiopia. We applied multi-level logistic regression and a p-value of <0.25 to include variables before modeling and a p-value<0.05 with 95% confidence interval (CI) for final results. Result The prevalence of caesarian section in Ethiopia was 5.44% (95% CI; 0.048-0.06) in2019. Women in age group of 30-39 and 40-49 years had a higher odd of caesarian section (AOR = 2.14, 95%CI = 1.55-2.94) and (AOR = 2, 95%CI = 1.20-3.97) respectively compared to women in age group of 15-29 years. Women with secondary and higher educational level had higher odds of caesarian section (AOR = 2.15, 95%CI = 1.38-3.34) and (AOR = 2.8, 95%CI = 1.73-4.53) compared to those in no education category. Compared to Orthodox, Muslims and Protestant religions had lower odds of caesarian section with AOR of 0.50 (0.34-0.73) and 0.53 (0.34-0.85). Having <2 births was also associated with the low caesarian section 0.61(0.52-1.22). Using modern contraceptive methods, having ANC visits of 1-3, 4th, 5 plus, and urban residence were associated with higher odds of caesarian section as 1.4 (1.05-1.80]), 2.2 (1.51-3.12), 1.7 (1.12-2.46), and 2.4 (1.65-3.44) 1.6(1.04-2.57) respectively. Conclusion Although evidence indicates that the caesarian deliveries increased both in developed and underdeveloped countries, the current magnitude of this service was very low in Ethiopia which might indicate missing opportunities that might costing lives of mothers and newborns. Women’s age, religion, educational status, parity, contraceptive method, and ANC visit were individual level factors influenced caesarian section. whereas, region and place of residence were community level factors affected caesarian section in the country. Depending on these factors, the country needs policy decisions for further national level interventions.

Individual and community-level factors associated with caesarean section in Haiti: secondary analysis of data from the 2016–2017 Haitian Demographic and Health Survey

“…Finally, we found that the more children women had, the less likely they were to undergo CS delivery. Our results align with other studies conducted in Rwanda [ 6 ], Kenya [ 39 ], and Ethiopia [ 24 , 77 ]. A possible explanation is that women who had 5 or more children had previously given birth successfully or experienced fewer complications requiring CS [ 24 , 69 , 78 ].…”

“…Our results align with other studies conducted in Rwanda [ 6 ], Kenya [ 39 ], and Ethiopia [ 24 , 77 ]. A possible explanation is that women who had 5 or more children had previously given birth successfully or experienced fewer complications requiring CS [ 24 , 69 , 78 ]. In addition, it should be noted that our data showed that women who had fewer children were those with higher education levels and gave births more at advanced maternal ages.…”

“…Greater maternal age is an important predictor associated with CS in Haiti. Supported by studies conducted in Europe [ 61 ], Asia [ 8 , 62 ], Oceania [ 63 ], and Africa [ 24 , 26 ], our findings indicated that women aged 35 years and above were more likely to undergo CS than those aged 25–34 years. The reasons for the increased likelihood of CS among women aged 35 years and above remain unclear [ 8 , 64 , 65 ]; however, it might be due to the fact that women of advanced maternal age (specifically first-time mothers) are more likely to have hypertension, diabetes, and experience preterm delivery [ 66 ], important risks factors for CS [ 8 ].…”

Prevalence of Cesarian Delivery and Associated Factors Among Mothers Who Gave Birth at Public Hospitals, Jigjiga, Ethiopia

“…10 Although data from nationwide health survey in 2019 revealed that the prevalence of the CS to be 5.44%. 11 However; there are some areas that CS become a popular method preferred by mothers and husbands for example, the urbanized areas; CS rates are twice as high as the maximum level of WHO recommendation. 12 A number of studies have been conducted recently to determine CS rates and associated factors.…”

Longitudinal path analysis for the directional association of depression, anxiety and posttraumatic stress disorder with their comorbidities and associated factors among postpartum women in Northwest Ethiopia: A cross-lagged autoregressive modelling study

“…The results of a meta-analysis study in China suggests that cesarean section mode of delivery increased the risk of postpartum depression [14]. Even though the Ethiopian national cesarean section rate ranged from 2% to 29.55% [15][16][17], mode of delivery was not found to be associated with postpartum depression in Ethiopian study [12]. The risk factors for postpartum anxiety that have been best established are poor physical health, unplanned pregnancy, low partner support, lack of control during labor, pain, and postpartum depression [18].…”