Individual and community factors associated with indications of caesarean delivery in Southern Nigeria: Pooled analyses of 2003–2013 Nigeria demographic and health surveys

Solanke, Bola Lukman

doi:10.1080/07399332.2018.1443107

Cited by 11 publications

(13 citation statements)

References 58 publications

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“…The association between woman’s parity and the likelihood to have a CS delivery has been long-established in body literature. Conventionally, mothers with higher birth order are less likely to have a CS [24, 25, 33]. The results of the current study are consistent with previous research in this area.…”

Section: Discussionsupporting

confidence: 90%

“…Also, none of the studies quantified the extent of inequality using concentration index and curve. This study aims to contribute to a growing international policy-relevant body of literature examining the effect of socioeconomic factors on CS delivery [31–33] . The goal of this study is to investigate the association between CS delivery and socioeconomic factors using nationally representative data from Ghana.…”

Section: Introductionmentioning

confidence: 99%

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Socioeconomic inequalities in the use of caesarean section delivery in Ghana: a cross-sectional study using nationally representative data

Dankwah

Kirychuk

Zeng

et al. 2019

Int J Equity Health

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BackgroundInappropriate use of Caesarean Section (CS) delivery is partly to blame for Ghana’s high maternal mortality rate. However, previous research offered mixed findings about factors associated with CS use. The goal of this study is to examine use of CS in Ghana and the socioeconomic factors associated with it.MethodsData from the nationally representative 2014 Ghana Demographic and Health Survey (GDHS) was used after permission from the Monitoring and Evaluation to Assess and Use Results (MEASURE) Demographic and Health Survey (DHS) program. Univariable and multivariable logistic regression models were fitted to examine the socioeconomic inequalities in CS use. The independent variables included maternal age, marital status, religion, ethnicity, education, place of residence, wealth quintile, and working status. Concentration index (CI) and rate-ratios were computed to ascertain the level of CS inequalities.ResultsOut of the 4294 women, 11.4% had CS delivery. However, the percentage of CS delivery ranged from 5% of women in the poorest quintile to 27.5% of women in the richest qunitle. Significant associations were detected between CS delivery and maternal age, parity, education, and wealth quintile .ConclusionsThis study revealed that first, even though Ghana has achieved an aggregate CS rate consistent with WHO recommendations, it still suffers from inequities in the use of CS. Second, both underuse of CS among poorer women in Ghana and overuse among rich and educated women are public health concerns that need to be addressed. Third, the results show in spite of Ghana’s free maternal care services policies, wealth status of women continues to be strongly and signtificantly associated with CS delivery, indicating that there are indirect health care costs and other reasons preventing poorer women from having access to CS which should be understood better and addressed with appropriate policies.

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Section: Discussionsupporting

confidence: 90%

Section: Introductionmentioning

confidence: 99%

Socioeconomic inequalities in the use of caesarean section delivery in Ghana: a cross-sectional study using nationally representative data

Dankwah

Kirychuk

Zeng

et al. 2019

Int J Equity Health

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“…The pooling generated a large sample size sufficient for drawing valid inference on the socio-demographic factors associated with delayed childbearing. This technique has been adopted in a number of studies that analysed Demographic and Health Survey (DHS) data [18]. Comprehensive details of the DHS design and methodology are widely available [19–21].…”

Section: Methodsmentioning

confidence: 99%

Socio-demographic factors associated with delayed childbearing in Nigeria

Solanke¹,

Salau²,

Popoola³

et al. 2019

BMC Res Notes

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Objective Delayed childbearing is an emerging public health issue in developing countries compared with more developed countries, where it is already a major clinical and public health concern. Previous studies have mostly focused on either the health risks associated with delayed childbearing or the reasons for it with little done around the socio-demographic factors associated with it in developing countries. The objective of the study was to examine associated socio-demographic factors of delayed childbearing in Nigeria. Results The study used secondary data pooled from 2003 to 2013 Nigeria Demographic and Health Surveys. The outcome variable was delayed childbearing. The explanatory variables are selected individual socio-demographic characteristics and community characteristics. A weighted sample size of 20,550 women was analysed. Results showed a prevalence of 8.0% delayed childbearing in Nigeria. Socio-demographic factors such as higher maternal education, age at first marriage of 25 years or older, modern contraceptive use, and remarriage status were significantly associated with delayed childbearing. Significant associations were also observed with high community literacy level and high proportion of women who ever used modern contraceptive in the community.

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“…Some multilevel studies in Tanzania [23], Nigeria [24], Zambia [25], Kenya [26] and India [27,28] reported that a community-level effect strongly predicted PNC services use, after controlling for individual-level predictors. In addition, these previous studies estimated different community-level effects of communities on the utilization of PNC services; for example Mohan et al [23] and Solanke et al [29] reported that 12% and 37.2% unexplained community variance respectively accounted for the variability in PNC services use. Many methodological limitations accompanied these contradictory ndings including the use of a limited number of independent variables and inadequate adjustment for confounding.…”

Section: Ghana Had 10 Administrative Regions During the 2014 Ghana Dementioning

confidence: 99%

Assessing the Contextual Effect of Community in the Utilization of Postnatal Care Services in Ghana

Dankwah

Zeng

Feng

et al. 2020

Preprint

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Background Inequalities in the use of postnatal care services (PNC) in Ghana have been linked to poor maternal and neonatal health outcomes. This has ignited a genuine concern that PNC interventions with a focus on influencing solely individual-level risk factors do not achieve the desired results. This study aimed to examine the community-level effect on the utilization of postnatal care services. Specifically, the research explored clusters of non-utilization of PNC services as well as the effect of community-level factors on the utilization of PNC services, with the aim of informing equity-oriented policies and initiatives. Methods The 2014 Ghana Demographic and Health Survey GDHS dataset was used in this study. Two statistical methods were used to analyze the data; spatial scan statistics were used to identify hotspots of non-use of PNC services and second two-level mixed logistic regression modeling was used to determine community-level factors associated with PNC services usage. Results This study found non-use of PNC services to be especially concentrated among communities in the Northern region of Ghana. Also, the analyses revealed that community poverty level, as well as community secondary or higher education level, were significantly associated with the utilization of PNC services, independent of individual-level factors. In fact, this study identified that a woman dwelling in a community with a higher concentration of poor women is less likely to utilize of PNC services than those living in communities with a lower concentration of poor women (Adjusted odds ratio (AOR) = 0.60, 95%CI: 0.44–0.81). Finally, 24.0% of the heterogeneity in PNC services utilization was attributable to unobserved community variability. Conclusion The findings of this study indicate that community-level factors have an influence on women’s health-seeking behavior. Community-level factors should be taken into consideration for planning and resource allocation purposes to reduce maternal health inequities. Also, high-risk communities of non-use of obstetric services were identified in this study which highlights the need to formulate community-specific strategies that can substantially shift post-natal use in a direction leading to universal coverage.

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Individual and community factors associated with indications of caesarean delivery in Southern Nigeria: Pooled analyses of 2003–2013 Nigeria demographic and health surveys

Cited by 11 publications

References 58 publications

Socioeconomic inequalities in the use of caesarean section delivery in Ghana: a cross-sectional study using nationally representative data

Socioeconomic inequalities in the use of caesarean section delivery in Ghana: a cross-sectional study using nationally representative data

Socio-demographic factors associated with delayed childbearing in Nigeria

Assessing the Contextual Effect of Community in the Utilization of Postnatal Care Services in Ghana

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