Caesarean section in a primary health facility in Ghana: Clinical indications and feto-maternal outcomes

Prah, James Kojo; Kudom, Andreas A; Afrifa, Alex Darteh; Abdulai, Mohammed Najimudeen; Sirikyi, Ignatius H.; Abu, Emmanuel Kwasi

doi:10.4081/jphia.2017.704

Cited by 21 publications

(43 citation statements)

References 11 publications

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“…The study from Ghana stated that the lack of assisted vaginal delivery and proper labour monitoring facilities made the mother less confident in choosing normal birth. 49 Whereas physician incompetency to handle complicated labour was suspected in one study from China. 42 A study from Nigeria documented that when women prefer CD, obstetricians are less likely to oppose this.…”

Section: Systematic Review Findingsmentioning

confidence: 99%

“…Out of ten available safeguards, the lowest count achieved was six, [50][51][52] and the highest count was 10. 40,41,44,53 Only a few of the studies mentioned the representativeness for the national population, 25,27,40,41,43,44,53,54 and some did not discuss representativeness against the target population, 26,28,45,46,[48][49][50][51][52][55][56][57][58][59][60] which jeopardised the external validity. The outcome definition for CDMR did not match in four articles, where previous CD was included as a reason for CDMR.…”

Section: Study Qualitymentioning

confidence: 99%

See 1 more Smart Citation

Global incidence of caesarean deliveries on maternal request: a systematic review and meta‐regression

Begum

Saif‐Ur‐Rahman

Fatima

et al. 2020

BJOG

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Background Caesarean delivery on maternal request (CDMR) is considered a significant contributor to the unprecedented increase in caesarean deliveries (CDs) for nonclinical reasons. Current literature lacks a reliable assessment of the rate of CDMR, which hinders the planning and delivery of appropriate interventions for reducing CDMR rates. Objectives To conduct a systematic review of the literature and meta‐regression to explore the global incidence of CDMR. Search strategy PubMed, Embase, CINAHL, Medline, Google scholar and grey literature were searched from January 1985 to May 2019. Selection criteria Observational studies that report CDMR data were included. We excluded non‐English articles, case notes, editorial reviews and articles reporting elective CDs from pregnancy risk factors. Data collection and analysis Two reviewers independently conducted the screening and quality appraisal using a validated tool. The weighted average of CDMR over total deliveries (absolute proportion) and by total CDs (relative proportion) were generated. Quality‐effects meta‐regression was used to explain the variability of the CDMR estimates by moderators, including study methodology and demography of study participants. Main results We identified 31 articles from 14 countries that include 5 million total births. The absolute proportion of CDMR varies between 0.2 and 42.0%, with significant variations across studies and subgroups. The economic status of the country and study year together explained 84% of the absolute and 76% of the relative proportion of CDMR variation. Conclusions An appropriate reporting of CDMR should be a key priority in maternal health policies and practices. Tweetable abstract Globally, the proportion of maternal requested caesarean delivery has mostly been influenced by the economic status of the country.

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Section: Systematic Review Findingsmentioning

confidence: 99%

Section: Study Qualitymentioning

confidence: 99%

Global incidence of caesarean deliveries on maternal request: a systematic review and meta‐regression

Begum

Saif‐Ur‐Rahman

Fatima

et al. 2020

BJOG

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“…Although there have been some studies on CD in Ghana, some of them focused on socioeconomic and demographic factors associated with CD in southern Ghana [14], preference of Ghanaian women for vaginal or CD postpartum [21], validating women's self-report of emergency CD [18], vaginal birth after a previous CS [22] and clinical indications and feto-maternal outcomes and predictors of CD in Northern Ghana [23]. As far as we know, none of these studies have used a nationally representative sample to assess prevalence and the factors associated with CD among childbearing women in Ghana despite the country recording an overall rate of 16% [24], above the threshold given by WHO.…”

Section: Introductionmentioning

confidence: 99%

Not just numbers: beyond counting caesarean deliveries to understanding their determinants in Ghana using a population based cross-sectional study

Seidu

Hagan

Agbemavi

et al. 2020

BMC Pregnancy Childbirth

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Background: The increasing rate of caesarean deliveries (CD) has become a serious concern for public health experts globally. Despite this health concern, research on factors associated CD in many low-and -middle countries like Ghana is sparse. This study, therefore, assessed the prevalence and determinants of CD among child-bearing women aged 15-49 in Ghana. Methods: The study used data from the 2014 Ghana Demographic and Health Survey. The analysis was limited to mothers (n = 2742) aged 15-49 , who had given birth in health facilities 5 years preceding the survey. Association between CD and its determinants was assessed by calculating adjusted odds ratios (AOR) with their respective 95% confidence intervals using a binary logistic regression. Results: The percentage of mothers who delivered their babies through caesarean section (CS) was 18.5%. Using multivariable logistic regression, the results showed that women aged 45-49 (AOR = 10.5; 95% CI: 3.0-37.4), and women from a household that are headed by a female (AOR = 1.3; 95% CI = 1.1-1.7) had higher odds to deliver through CS. Women from the Upper East (AOR =0.4; 95% CI = 0.2-0.7) and Upper West (AOR = 0.4; 95% CI = 0.2-0.8) regions had lower odds to deliver their children through CS. Women with parity 4 or more (AOR = 0.3; 95% CI = 0.2-0.5) had lower odds of CD compared to those with parity 1. Women with female babies had lower odds (AOR = 0.8; CI = 0.7-0.9) of delivering them through CS compared to those with male children. Conclusion: The percentage of women delivering babies through the CS in Ghana is high. The high rates of CD noted do not essentially indicate good quality care or services. Hence, health facilities offering this medical protocol need to adopt comprehensive and strict measures to ensure detailed medical justifications by doctors for performing these caesarean surgeries.

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“…A study conducted at the University of Cape Coast Teaching Hospital found a C/S rate of 26.9%. 63 Though there is inconsistency in the rate of C/S, it is clear the rates are relatively high. Moving forward there is, therefore, the need to do case reviews of C/S conducted in different hospitals to inform policy.…”

Section: Discussionmentioning

confidence: 99%

Reasons for the utilization of the services of traditional birth attendants during childbirth: A qualitative study in Northern Ghana

Tabong

Kyilleh

Amoah

2021

Womens Health (Lond Engl)

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Background: Skilled delivery reduces maternal and neonatal mortality. Ghana has put in place measures to reduce geographical and financial access to skilled delivery. Despite this, about 30% of deliveries still occur either at home or are conducted by traditional birth attendants. We, therefore, conducted this study to explore the reasons for the utilization of the services of traditional birth attendants despite the availability of health facilities. Method: Using a phenomenology study design, we selected 31 women who delivered at facilities of four traditional birth attendants in the Northern region of Ghana. Purposive sampling was used to recruit only women who were resident at a place with a health facility for an in-depth interview. The interviews were recorded and transcribed into Microsoft word document. The transcripts were imported into NVivo 12 for thematic analyses. Results: The study found that quality of care was the main driver for traditional birth attendant delivery services. Poor attitude of midwives, maltreatment, and fear of caesarean section were barriers to skilled delivery. Community norms dictate that womanhood is linked to vaginal delivery and women who deliver through caesarean section do not receive the same level of respect. Traditional birth attendants were believed to be more experienced and understand the psychosocial needs of women during childbirth, unlike younger midwives. Furthermore, the inability of women to procure all items required for delivery at biomedical facilities emerged as push factors for traditional birth attendant delivery services. Preference for squatting position during childbirth and social support provided to mothers by traditional birth attendants are also an essential consideration for the use of their services. Conclusion: The study concludes that health managers should go beyond reducing financial and geographical access to improving quality of care and the birth experience of women. These are necessary to complement the efforts at increasing the availability of health facilities and free delivery services.

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Caesarean section in a primary health facility in Ghana: Clinical indications and feto-maternal outcomes

Cited by 21 publications

References 11 publications

Global incidence of caesarean deliveries on maternal request: a systematic review and meta‐regression

Global incidence of caesarean deliveries on maternal request: a systematic review and meta‐regression

Not just numbers: beyond counting caesarean deliveries to understanding their determinants in Ghana using a population based cross-sectional study

Reasons for the utilization of the services of traditional birth attendants during childbirth: A qualitative study in Northern Ghana

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