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. 2019 Jun 17;9(6):e027273.
doi: 10.1136/bmjopen-2018-027273.

Cesarean delivery in Nigeria: prevalence and associated factors-a population-based cross-sectional study

Emmanuel O Adewuyi  1   2 , Asa Auta  3 , Vishnu Khanal  4 , Samson J Tapshak  5 , Yun Zhao  6
Affiliations

Cesarean delivery in Nigeria: prevalence and associated factors-a population-based cross-sectional study

Emmanuel O Adewuyi et al. BMJ Open. .

Abstract

Objective: To investigate the prevalence and factors associated with caesarean delivery in Nigeria.

Design: This is a secondary analysis of the nationally representative 2013 Nigeria Demographic and Health Survey (NDHS) data. We carried out frequency tabulation, χ2 test, simple logistic regression and multivariable binary logistic regression analyses to achieve the study objective.

Setting: Nigeria.

Participants: A total of 31 171 most recent live deliveries for women aged 15-49 years (mother-child pair) in the 5 years preceding the 2013 NDHS was included in this study.

Outcome measure: Caesarean mode of delivery.

Results: The prevalence of caesarean section (CS) was 2.1% (95% CI 1.8 to 2.3) in Nigeria. At the region level, the South-West had the highest prevalence of 4.7%. Factors associated with increased odds of CS were urban residence (adjusted OR (AOR): 1.51, 95% CI 1.15 to 1.97), maternal age ≥35 years (AOR: 2.12, 95% CI 1.08 to 4.11), large birth size (AOR: 1.39, 95% CI 1.10 to 1.74) and multiple births (AOR: 4.96, 95% CI 2.84 to 8.62). Greater odds of CS were equally associated with maternal obesity (AOR: 3.16, 95% CI 2.30 to 4.32), Christianity (AOR: 2.06, 95% CI 1.58 to 2.68), birth order of one (AOR: 3.86, 95% CI 2.66 to 5.56), husband's secondary/higher education level (AOR: 2.07, 95% CI 1.29 to 3.33), health insurance coverage (AOR: 2.01, 95% CI 1.37 to 2.95) and ≥4 antenatal visits (AOR: 2.84, 95% CI 1.56 to 5.17).

Conclusions: The prevalence of CS was low, indicating unmet needs in the use of caesarean delivery in Nigeria. Rural-urban, regional and socioeconomic differences were observed, suggesting inequitable access to the obstetric surgery. Intervention efforts need to prioritise women living in rural areas, the North-East and the North-West regions, as well as women of the Islamic faith.

Keywords: Nigeria; caesarean section; epidemiology; maternal health; public health; reproductivemedicine.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Prevalence of caesarean section by rural–urban residence in Nigeria.
Figure 2
Figure 2
Prevalence of caesarean section by region of residence in Nigeria.
See this image and copyright information in PMC

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References

    1. WHO. WHO Statement on Caesarean Section Rates. Geneva: World Health Organization. Geneva 2015.
    1. Gibbons L, Belizan JM, Lauer JA, et al. . Inequities in the use of cesarean section deliveries in the world. Am J Obstet Gynecol 2012;206(4):331.e1–331.e19. e1-31. e19 10.1016/j.ajog.2012.02.026 - DOI - PubMed
    1. Baron YM. Does the 10–15% caesarean section rate threshold established by the WHO in 1985 still apply for modern obstetrics in developed countries? Eur J Obstet Gynecol Reprod Biol 2016;206:e81.
    1. Gibbons L, Belizán JM, Lauer JA, et al. . The global numbers and costs of additionally needed and unnecessary caesarean sections performed per year: overuse as a barrier to universal coverage. World health report 2010;30:1–31.
    1. WHO. UNFPA, UNICEF. AMDD: Monitoring emergency obstetric care: a handbook. Geneva 2009.