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Public health
Research
Cesarean delivery in Nigeria: prevalence and associated factors―a population-based cross-sectional study
  1. Emmanuel O Adewuyi1,2,
  2. Asa Auta3,
  3. Vishnu Khanal4,
  4. Samson J Tapshak5,
  5. Yun Zhao6
  1. 1Statistical and Genomic Epidemiology Laboratory, Institute of Health and Biomedical Innovation, School of Biomedical Sciences, Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia
  2. 2Pharmacy Department, 2 Division Hospital, Ibadan, Oyo State, Nigeria
  3. 3School of Pharmacy and Biomedical Sciences, University of Central Lancashire, Preston, UK
  4. 4Nepal Development Society, Bharatpur, Nepal
  5. 5Department of Obstetrics and Gynaecology, Chivar Specialist Hospital, and Urology Centre Ltd, Abuja, Nigeria
  6. 6Department of Epidemiology and Biostatistics, School of Public Health, Curtin University, Perth, Western Australia, Australia
  1. Correspondence to Mr Emmanuel O Adewuyi; emmanuel.adewuyi{at}qut.edu.au

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.

  • caesarean section
  • epidemiology
  • maternal health
  • reproductivemedicine
  • public health
  • Nigeria

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi-org.ezproxy.u-pec.fr/10.1136/bmjopen-2018-027273

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    Footnotes

    • Contributors EOA designed the study, analysed the data and drafted the manuscript. YZ and VK contributed to the analysis and interpretation of findings. AA and SJT contributed to interpretation of findings, and revisions. All authors contributed to the critical revision of the manuscript and agreed on the final draft.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Ethics approval Ethical approval for the conduct of the 2013 NDHS was provided by the Nigerian National Health Research Ethics Committee. Participants provided written informed consent by themselves, and those who were younger than 18 years at the time of the survey had consent provided on their behalf by parents/guardians. The present study was based on a secondary analysis of the completely anonymised data from the survey; hence, no additional ethical clearance was required. Permission to use the data was obtained from the Measure DHS/ICF International, USA.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data sharing statement The data analysed in this study are publicly and freely available on the repository of the DHS programme at https://www.dhsprogram.com/data/available-datasets.cfm. Access and permission to use the data are freely granted following online request on the DHS programme’s website (www.dhsprogram.com).

    • Patient consent for publication Not required.