The Influence of Personal and Socioeconomic Factors on the Demand for Caesarean Section among Female Healthcare Workers at the Komfo Anokye Teaching Hospital, Kath
International Journal of Research and Reports in Gynaecology,
Introduction: There has been increase in the Demand for Caesarean Section (CS) or Caesarean Delivery on Maternal Request (CDMR) in recent years with increasing financial and resource burden on health care delivery especially in resource poor settings including Ghana. This study was conducted to ascertain the factors influencing the demand for Caesarean delivery among female health workers at the Komfo Anokye Teaching Hospital, Kumasi. The objectives of the study were to find out the impact of Personal and Socioeconomic factors on the demand of caesarean section.
Methods: The study was a descriptive cross-sectional conducted among 351 randomly selected female health staff from the Komfo Anokye Teaching Hospital. Data was captured with the use of questionnaires and analysed using descriptive statistics.
Results and Findings: Almost 3 in 10 (27.7%) of health workers delivered through Cesarean Section. Fourteen percent indicated that they would willingly demand for CS for several reasons; with “avoiding labor pains” as the most cited reason. Factors that influenced demand for CS were negative birth experiences (OR=3.9; 95% CI=0.4, 29.6) and having problems during pregnancy (OR=17.9; p<0.001), mothers’ income or ability to pay (OR=2.6; p=0.01), spousal influence (23.7%), level of education (23.2%) and sexually satisfying spouse (18.9%). Others were availability of competent specialist/staff, 49.6%, advanced technology, 24.1% and success stories of CS from peers (26.3%) and belonging to the National Health Insurance scheme (OR=12.7; p<0.001), human resource capacity (OR=8.3; p<0.001) and being a health staff (OR=2.7; 95% CI=1.2, 5.7; p=0.01).
Conclusion: Some Healthcare workers 14% (49) indicated they would demand CS. Understanding women’s reasons behind demanding for CS is necessary to avoid unnecessary CS and help to channel the resources involved to other pertinent areas of health delivery.
- Ceasarean section
- socio-economic and personal factors
- health staff
How to Cite
Matshidze k, Richter L, Ellison G, Mc intyre J. Caesarean Section Rates in South Africa: Evidence of bias among different population groups. PMC. 2007;3:71- 79.
Moyer C, Elsayed Y, Zhu Y, Engmann C, Yang H. Is generalized maternal Optimism or Pessimism during Pregnancy Associated with Unplanned caesarean Section Deliveries in China? Journal of Pregnancy. 2010;754938.
Abalos E. Surgical Techniques for Caesarean Section: RHL Commentary. The WHO Reproductive Health Library; Geneva: World Health Organization;2009.
Annual report. Reproductive and Child Health Unit: Public Health Division, Ghana Health Service. 2003;23.
Appeawusu A. Incidence of Caesarean Section in New Guinea. PNG Medical Journal. 1997;40:127-135.
Boley JP. The history of caesarean section. Canadian Medical association journal. 1991;151(4):319-322
Donabedian A. The seven pillars of quality Arch Pathol Lab Med. 1990;114(11):1115-8.
Emedicinehealth. Ceasarian birth; 2011.
Kmietowicz Z. NICE advice against caesarean section on demand”. BMJ. 2004;328:1031.
Nilstun T. Caesarean delivery on maternal Request: Can the ethical problem be solved by the Principalist approach. BMC medical Ethics. 2008;9:11.
Olubusola A, Sasha R, Ibrahim I. Bolaji. BMJ.1998;317:462-465.
Salvador J, Cano-Serral G, Rodriquez-Sanz M, Lladonosa A, Borrell C. Inequalities in caesarean section: Influence of type of the maternity care and social class in an area with national health system. J Epidemiol community Health. 2009;68:259-261.
Danso KA. Adageba RK, Adusu-Donkor A, Ankobea-Kokroe F. Awareness and perceptions of and Attitudes towards Caesarean Delivery among Antenatal, Ghana Medical Journal, GMJ. 2008;42: 4.
Komfo Anokye Teaching Hospital, KATH.
Klein MC. “Elective caesarean section”. CMAJ. 2004;171(1).
WHO. Recommended Caesarean rates;1998.
Available:http://www.sciencebasedmedicine.org/index.php/whats - the right - c – section – rate – higher than – you – think/
WHO’s Global survey on Maternal and Perinatal health 2004 and 2005.
Shah A, Faundes A, Machoki M, Bataglia V, Amokrane F, Donner A, Mugerwa K, Carroli G, Fawole B, Langer A, Wolomby J.J, Naravaez A, Nafiou I, Kublickas M, Valladares E, Velasco A , Zavaleta N, Neves I, Villar J. Methodological considerations in implementing the WHO Global Survey for Monitoring Maternal and Perinatal Health. Bulletin of the World Health Organization. 2008;86(2):126- 131.
Souza JP, Gulmezoglu AM, Lumbiganon P, Laopaiboon M, Carroli G, Fawole B, Ruyan P. Caesarean section without medical indications is associated with an increased risk of adverse short-term maternal outcomes: the 2004–2008 WHO Global Survey on Maternal and Perinatal Health. BMC Medicine. 2010;8(1): 71.
Souza JP, Gulmezoglu AM, Lumbiganon P, Laopaiboon M, Carroli G, Fawole B, Ruyan P. Should caesarean section be performed on request? BMJ. 2011; 342.
DOI: 10.1136/bmj. D276
Sufang G, Padmadas SS, Fengmin Z , Brown JJ, Stones RW. Delivery settings and caesarean section rates in China. Bulletin of the World Health Organization. 2007;85(733-820).
Weller BJ. Bailliere’s Nurses’ Dictionary, 24th Edition, Elsevier Science Limited, USA;2005.
World Health Report. Background Paper 29, on “Determinants of caesarean section rates in developed countries: Supply, demand and opportunities for control. WHO; 2010.
Kirkwood BR, Sterne JAC. Essential medical statistics. 2ndEdition, Oxford: Blackwell Scientific; 2003.
Deneux-Tharau C, Carmona E, Bouvier-Colle MH, Breart G . Postpartum maternal mortality and caesarean delivery. Obstet Gynaecol. 2006;108(3 pt1):541–548.
Ncayiyana DJ. Elective abdominal delivery-should women have the right to choose?. South Afr Med. J. 2005;95(4): 192
Awoyinka BS, Ayinde OA, Omigbodun AO. Acceptability of caesarean delivery to antenatal patients in a tertiary health facility in South West Nigeria. J Obstet Gynaecol. 2006;26(3):208-10.
WHO. Caesarean section without medical indication increases risk of short-term adverse outcomes for mothers. WHO/RHR/HRP/10.20; 2010.
Al-Mufti R, McCarthy A, Fisk NM. Obstetrician’s personal choice and mode of delivery. Lancet. 1996;347:554
Alder J. Tschudin S, Hendriksen S, Bitzer J, Popp KA, Zanetti R, Hösli I, Holzgreve W, Geissbühler V. Pregnant women’s Perception of CS on demand”. Gruyter. 2009;37(3).
Barros FC, Behague DP, Cesar GV. Caesarean Sections in Brazil: Informed decision-making, patient choice, or social inequality? A population based Cohort study. BMJ. 2002;324:16
Belizan JM, Athabe F, Barros FC, Alexander S. Rates and Implications of Caesarean sections in Latin America: Ecological study, BMJ. 1999;319:1397–1402.
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