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Changing the Discourse on Caesarean Births in India: Issues emerging from NFHS-5 (2019–2021)

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Abstract

With increasing institutional deliveries, India has witnessed an increasing prevalence of caesarean births since 2005–2006, which by 2019–2021 increased a manifold more than WHO’s estimated acceptable proportion. The paper envisages addressing the critical research question of whether private health facilities and providers are fuelling caesarean births, which could have otherwise been avoided in the overall institutional deliveries in India? Data used are from the two rounds of Indian DHS, known as NFHS. Findings are from NFHS-5 (2019–2021) with the corresponding values from NFHS-4 (2015–2016). Descriptive statistics, bivariate, and multivariate regression analysis have been used to portray caesarean births' significant cofactors across 36 states/UTs at state, 707 districts. Twenty-two percent of live births in India in the five years preceding NFHS-5 (2019–2021) were caesarean births, up from 17 percent in 2015–2016 and 9 percent in 2005–2006. Caesarean deliveries among the births in private health facilities were as high as 47 percent. The predicted probabilities of caesarean births substantially increased over the last five years, especially among young mothers, those having lower order births, well educated, and delivering in private health facilities. Disproportionately higher caesarean births in private health facilities, especially among young mothers having lower order births, exist in different states/districts despite the recent opposition to such a high prevalence of caesarean births. As a substantial proportion of caesarean births are provider-driven avoidable operations, where higher financial gains may be the real motive, it should be minimized.

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Data availability

The data used in this study are available in the public domain of NFHS website http://rchiips.org/nfhs/factsheet_NFHS-5.shtml.

Abbreviations

NFHS:

National Family Health Survey

IIPS:

International Institute for Population Sciences

MoHFW:

Ministry of Health and Family Welfare

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Acknowledgements

The authors of the paper acknowledge the NFHS team at IIPS for releasing the district and state-level fact sheet to conduct this research.

Funding

This research did not receive a specific grant from any funding agency, commercial entity, or nor-for-profit organization.

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Authors and Affiliations

  1. Department of Mathematical Demography & Statistics, International Institute for Population Sciences, Govandi Station Road, Deonar, Mumbai, 400088, India

    Shri Kant Singh &  Aditi

  2. International Institute for Population Sciences, Govandi Station Road, Deonar, Mumbai, 400 088, India

    Santosh Kumar Sharma

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  1. Shri Kant Singh
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  2. Aditi
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  3. Santosh Kumar Sharma
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Contributions

S.K.S.: conceptualization, methodology, investigation, writing, reviewing, and editing. A.: interpretation, writing, reviewing, and editing; S.K.S.: data preparation, methodology, formal analysis, reviewing, and editing.

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Correspondence to Santosh Kumar Sharma.

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Since the study has used secondary data which are available in public domain, no consent to participate was needed.

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Singh, S.K., Aditi & Sharma, S.K. Changing the Discourse on Caesarean Births in India: Issues emerging from NFHS-5 (2019–2021). SN Soc Sci 2, 103 (2022). https://doi.org/10.1007/s43545-022-00406-8

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