Skip to main content

Advertisement

Log in

The role of demographic and socioeconomic factors, leave policy and government institutions in CS deliveries in Ghana

  • Original Article
  • Published:
Journal of Public Health Aims and scope Submit manuscript

Abstract

Aim

Caesarean section deliveries in Ghana increased from 6 to 13% between 2008 and 2014. This current rate is dangerously close to the safe limit suggested by the World Health Organisation (WHO) and is particularly concerning in the absence of a negative correlation between the rising CS rates and neonatal mortality in the country. The research therefore examines the factors correlated with caesarean section delivery in Ghana, with an aim to making research-based policy suggestions to curb the observed trends.

Subjects and methods

The 2014 Ghana Demographic and Health Survey is employed for the analysis, and a probit model is used to examine the effects of demographic and socioeconomic factors, maternal leave policy and government health institutions on the likelihood of caesarean section deliveries in Ghana. The analysis uses the last births of 1284 women of childbearing age in the country.

Results

The results indicate that demographic and socioeconomic factors are important determinants of caesarean section deliveries. While antenatal care attendance at government institutions reduces the likelihood of caesarean section, deliveries in government health facilities are more likely to be done by caesarean section. Interestingly, women with previous pregnancy complications are not significantly more likely to have a caesarean section delivery. This might indicate that many caesarean sections performed in the country may be elective and not necessarily medically necessary.

Conclusions

Child and maternal survivals are often given as justifications for caesarean section deliveries. The absence of a negative relationship between increasing caesarean section rates and neonatal mortality in the country therefore creates some concern.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  • Adasekh JA, Peaceman AM, Lopez-Zeno JA, Minogue JP, Socol ML (1993) Factors contributing to the increased birth rate in older parturient women. Am J Obstet Gynecol 169:936–940

  • Althabe F, Sosa C, Belizán JM, Gibbons L, Jacquerioz F, Bergel E (2006) Cesarean section rates and maternal and neonatal mortality in low-, medium-, and high- income countries: an ecological study. Birth 33(4):270–277

    Article  PubMed  Google Scholar 

  • Asante F, Chikwama C, Daniels A, Armar-Klemesu M (2007) Evaluating the economic outcomes of the policy of fee exemption for maternal delivery care in Ghana. Ghana Med J 41(3):110–117

    PubMed  PubMed Central  Google Scholar 

  • Bayou YT, Mashalla YJS, Thupayagale-Tshweneagae G (2016) Patterns of caesarean-section delivery in Addis Ababa, Ethiopia. Afr J Prm Health Care Fam Med 8(2):953

    Google Scholar 

  • Bottoms SF, Rosen MG, Sokol RJ (1980) The increase in caesarean birth rate. Med Int 302:559–565

    CAS  Google Scholar 

  • Bragg F, Cromwell DA, Edozien LC, Gurol-Unganci I, Mahmood TA, Templeton A, van der Meulen JH (2010) Variation of caesarean section among English NHS trusts after accounting for maternal and clinical risk: cross sectional study. Br Med J 341:c5065

    Article  Google Scholar 

  • Danso KA, Schwandt HM, Turpin CA, Seffah JD, Samba A, Hindin MJ (2009) Preference of Ghanaian women for vaginal or caesarean delivery postpartum. Ghana Med J 43(1):29–33

    PubMed  PubMed Central  Google Scholar 

  • Gibbons, L, Belizan, J M, Lauer, J A, Betran, A P, Merialdi, M, Althabe, F (2010) 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 background paper No. 30

  • Hall MH, Bewley S (1999) Maternal mortality and mode of delivery. Lancet 354:776

    Article  CAS  PubMed  Google Scholar 

  • Hobcraft JN, McDonald JW, Rutstein SO (1984) Socioeconomic factors in infant and child mortality: a cross-national Comparison. Popul Stud XXXVIII:193–223

    Article  Google Scholar 

  • Kahsay S, Berhe G, Gebremariam A, Betel Birhane B (2015) Determinants of caesarean deliveries and its major indications in Adigrat hospital, northern Ethiopia: a case control study. Epidemiology (sunnyvale) 5:192. doi:10.4172/2161-1165.1000192

    Article  Google Scholar 

  • Lauer J, Betran AP, Merialdi M, Wojdyla D (2010) Determinants of CS rates in developed countries: supply, demand and opportunities for control. World Health Report Background Paper, No. 29

  • McGovern P, Dowd B, Gjerdingen D, Dagher R, Ukestad L, McCaffrey D, Lundberg U (2007) Mothers' health and work-related factors at 11 weeks postpartum. Ann Fam Med 5:519–527

  • Mishra US, Ramanathan M (2002) Delivery-related complications and determinants of CS rates in India. Health Policy Plan 17(1):90–98

    Article  CAS  PubMed  Google Scholar 

  • Neuman M, Alcock G, Azad K, Kuddus A, Osrin D, More NS, Prost A (2014) Prevalence and determinants of caesarean section in private and public health facilities in underserved south Asian communities: cross-sectional analysis of data from Bangladesh, India and Nepal. BMJ Open 4(12):e005982

    Article  PubMed  PubMed Central  Google Scholar 

  • Peippert JF, Bracken MB (1993) Maternal age: an independent risk factor in the caesarean delivery. Obstet Gynaecol 81:200–205

    Google Scholar 

  • Pomeroy A, Koblinksy M, Alva S (2010) Private delivery care in developing countries: trends and determinants. DHS Working document No.76

  • Stoddard C, Stock W, Hogenson E (2015) The impact of maternity leave Laws on cesarean delivery. The B.E. J Econ Anal Policy 16(1):321–364. doi:10.1515/bejeap-2015-0015

    Google Scholar 

  • Villar J, Valladares E, Wojdyla D, Zavaleta N, Carroli G, Velazco A, Shah A, Campodónico L, Bataglia V, Faundes A, Langer A, Narváez A, Donner A, Romero M, Reynoso S, de Pádua KS, Giordano D, Kublickas M, Acosta A (2006) Caesarean delivery rates and pregnancy outcomes: the 2005 WHO global survey on maternal and perinatal health in Latin America. Lancet 367(9525):1819–1829

    Article  PubMed  Google Scholar 

  • Villar J, Carroli G, Zavaleta N, Donner A, Wojdyla D, Faundes A, et al (2007) Maternal and neonatal individual risks and benefits associated with caesarean delivery: multicentre prospective study. BMJ 335(7628):1025

  • World Health Organization (1985) Appropriate technology for birth. Lancet 2:436–437

    Google Scholar 

  • World Health Organization (2009) Monitoring emergency obstetric care: a Handbook. WHO Press, Geneva

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Nkechi S. Owoo.

Ethics declarations

Ethical statement

The authors declare that they have no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Owoo, N.S., Lambon-Quayefio, M.P. & Onuoha, N.A. The role of demographic and socioeconomic factors, leave policy and government institutions in CS deliveries in Ghana. J Public Health 25, 557–564 (2017). https://doi.org/10.1007/s10389-017-0816-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10389-017-0816-1

Keywords

Navigation