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dc.contributor.authorGunn, Jayleen K. L.
dc.contributor.authorEhiri, John E.
dc.contributor.authorJacobs, Elizabeth T.
dc.contributor.authorErnst, Kacey C.
dc.contributor.authorPettygrove, Sydney
dc.contributor.authorCenter, Katherine E.
dc.contributor.authorOsuji, Alice
dc.contributor.authorOgidi, Amaka G.
dc.contributor.authorMusei, Nnabundo
dc.contributor.authorObiefune, Michael C.
dc.contributor.authorEzeanolue, Chinenye O.
dc.contributor.authorEzeanolue, Echezona E.
dc.date.accessioned2017-06-05T23:08:47Z
dc.date.available2017-06-05T23:08:47Z
dc.date.issued2017-03-29
dc.identifier.citationPrevalence of Caesarean sections in Enugu, southeast Nigeria: Analysis of data from the Healthy Beginning Initiative 2017, 12 (3):e0174369 PLOS ONEen
dc.identifier.issn1932-6203
dc.identifier.doi10.1371/journal.pone.0174369
dc.identifier.urihttp://hdl.handle.net/10150/623940
dc.description.abstractBackground In order to meet the Sustainable Development Goal to decrease maternal mortality, increased access to obstetric interventions such as Caesarean sections (CS) is of critical importance. As a result of women's limited access to routine and emergency obstetric services in Nigeria, the country is a major contributor to the global burden of maternal mortality. In this analysis, we aim to establish rates of CS and determine socioeconomic or medical risk factors associated with having a CS in Enugu, southeast Nigeria. Methods Data for this study originated from the Healthy Beginning Initiative study. Participant characteristics were obtained from 2300 women at baseline via a semi-structured questionnaire. Only women between the ages of 17-45 who had singleton deliveries were retained for this analysis. Post-delivery questionnaires were used to ascertain mode-of-delivery. Crude and adjusted logistic regressions with Caesarean as the main outcome are presented. Results In this sample, 7.22% women had a CS. Compared to women who lived in an urban setting, those who lived in a rural setting had a significant reduction in the odds of having a CS (aOR: 0.58; 0.38-0.89). Significantly higher odds of having a CS were seen among those with high peripheral malaria parasitemia compared to those with low parasitemia (aOR: 1.54; 1.04-2.28). Conclusion This study revealed that contrary to the increasing trend in use of CS in low-income countries, women in this region of Nigeria had limited access to this intervention. Increasing age and socioeconomic proxies for income and access to care (e.g., having a tertiary -level education, full-time employment, and urban residence) were shown to be key determinants of access to CS. Further research is needed to ascertain the obstetric conditions under which women in this region receive CS, and to further elucidate the role of socioeconomic factors in accessing CS.
dc.description.sponsorshipEunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD); National Institute of Mental Health (NIMH); President's Emergency Plan for AIDS Relief (PEPFAR) [R01HD075050]; Healthy Sunrise Foundationen
dc.language.isoenen
dc.publisherPUBLIC LIBRARY SCIENCEen
dc.relation.urlhttp://dx.plos.org/10.1371/journal.pone.0174369en
dc.rights© 2017 Gunn et al. This is an open access article distributed under the terms of the Creative Commons Attribution Licenseen
dc.titlePrevalence of Caesarean sections in Enugu, southeast Nigeria: Analysis of data from the Healthy Beginning Initiativeen
dc.typeArticleen
dc.contributor.departmentUniv Arizona, Dept Epidemiol & Biostat, Mel & Enid Zuckerman Coll Publ Hlthen
dc.contributor.departmentUniv Arizona, Ctr Cancen
dc.identifier.journalPLOS ONEen
dc.description.noteOpen Access Journal.en
dc.description.collectioninformationThis item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at repository@u.library.arizona.edu.en
dc.eprint.versionFinal published versionen
refterms.dateFOA2018-09-11T19:54:51Z
html.description.abstractBackground In order to meet the Sustainable Development Goal to decrease maternal mortality, increased access to obstetric interventions such as Caesarean sections (CS) is of critical importance. As a result of women's limited access to routine and emergency obstetric services in Nigeria, the country is a major contributor to the global burden of maternal mortality. In this analysis, we aim to establish rates of CS and determine socioeconomic or medical risk factors associated with having a CS in Enugu, southeast Nigeria. Methods Data for this study originated from the Healthy Beginning Initiative study. Participant characteristics were obtained from 2300 women at baseline via a semi-structured questionnaire. Only women between the ages of 17-45 who had singleton deliveries were retained for this analysis. Post-delivery questionnaires were used to ascertain mode-of-delivery. Crude and adjusted logistic regressions with Caesarean as the main outcome are presented. Results In this sample, 7.22% women had a CS. Compared to women who lived in an urban setting, those who lived in a rural setting had a significant reduction in the odds of having a CS (aOR: 0.58; 0.38-0.89). Significantly higher odds of having a CS were seen among those with high peripheral malaria parasitemia compared to those with low parasitemia (aOR: 1.54; 1.04-2.28). Conclusion This study revealed that contrary to the increasing trend in use of CS in low-income countries, women in this region of Nigeria had limited access to this intervention. Increasing age and socioeconomic proxies for income and access to care (e.g., having a tertiary -level education, full-time employment, and urban residence) were shown to be key determinants of access to CS. Further research is needed to ascertain the obstetric conditions under which women in this region receive CS, and to further elucidate the role of socioeconomic factors in accessing CS.


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