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

Abstract

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.

Association between media exposure and family planning in Myanmar and Philippines: evidence from nationally representative survey data

“…Other studies have demonstrated that mass media impacts women empowerment, including their ability to take household decisions on contraception [ 47 – 51 ]. For example, sexual partners who access diverse media platforms (e.g., television, radio, newspapers), communicate more about safer sexual practices and subsequently use contraceptives (e.g., condoms), and/or other family planning methods.…”

“…Other limitations might include the alterations in the coding of the study variables, which could potentially generate data extraction errors. However, no substantial modifications were done during coding and extraction within the current study [ 47 ]. Despite these limitations, the sample size allows for generalizability of findings in the studied countries because data used were nationally representative.…”

Predictors of home births among rural women in Ghana: analysis of data from the 2014 Ghana Demographic and Health Survey

“…Second, there is also the possibility of social desirable inherent with self-reporting and recall bias from the respondents. Other limitations could be errors associated with data extraction and curation and coding of procedures in charts and tables [38]. However, the coding and data extraction did not go through substantial changes.…”

Understanding the association between exposure to family planning messages and consistent condom use among never married men in Ghana

“…In Ghana, Central, Northern and Upper East regions are considered among the regions where birth rate is very high [ 72 ]. The trend has been attributed to high rates of unintended pregnancies due to sociocultural norms within the regions that support polygamous marriages and large family sizes and inadequate access to contraceptives [ 51 , 73 , 74 ]. Hence, the higher likelihood of consistent condom use among never married men who live in those regions could be an intervention to reduce the high fertility rates in the region.…”