Assessing Socio-Demographic Factors of Cesarean Delivery in India: Insights From National Family Health Survey-4

Abstract

Background: The rate of cesarean delivery has considerably increased in the world during the last few decades. This paper aims to investigate the prevalence and socio-demographic correlates of cesarean delivery in India with a focus on Bihar and Tamil Nadu, accounting for the lower and higher proportion of cesarean birth.Methods: The study is based on secondary data, collected from the latest National Family Health Survey in 2015-16 (NFHS-4). The present study is based on 190,898 most recent births during the five years preceding the survey. Bivariate and multivariate analyses were carried out to identify the factors associated with cesarean delivery.Results: The highest rate of cesarean delivery was observed in Telengana (60%) and followed by Andhra Pradesh (42%), Tamil Nadu (36%). C-section found to be negligible in low-income states, namely Bihar (7%), Madhya Pradesh (10%) and Jharkhand (11%). Multivariate analysis revealed that the prevalence of cesarean delivery was substantially higher among women who married at higher age, with first birth-order, women in the ‘obese’ category with higher education, those from upper quintile of household wealth. Similarly the incidence of cesarean birth was remarkably higher in private hospitals both in the Indian sample (OR 3.9, 95% CI: 3.77-4.03) and in the selected states, Bihar (12.86, 95% CI: 10.92-15.15) and Tamil Nadu (OR 2.74, 95% CI: 2.40-3.13), compared to the public hospitals. Conclusion: Our study revealed that there are a high proportion of women delivering babies through cesarean section in South India. Thus, medical justifications need to be taken to deal with this concern. On the other hand, Women should also be driven towards regular ANC check-ups for the well-being of maternal and newborn health that can also help to increase the cesarean delivery for women who need C-section delivery especially in low-income states.

What to scale first? A cross-sectional analysis of factors affecting cesarean delivery rates at first referral units in Bihar, India

“…With primary level facilities not performing caesarean deliveries, FRUs represent the gateway to obstetrical care for Bihar’s predominantly rural population. Although studies have analysed caesarean rates at regional and state levels, there is a paucity of granular data on caesarean operations being performed specifically at FRUs [ 15 , 16 ]. The primary aim of this study was to identify caesarean delivery rates at Bihar’s FRUs stratified by hospital level (regional, sub-district, district).…”