Community factors affecting rising Caesarean section rates in developing countries: an analysis of six countries

Leone, Tiziana, Padmadas, Sabu S. and Matthew, Zoë (2008) Community factors affecting rising Caesarean section rates in developing countries: an analysis of six countries. Social Science & Medicine, 67, (8), 1236-1246. (doi:10.1016/j.socscimed.2008.06.032).


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Caesarean section rates have risen dramatically in several developing countries, especially in Latin America and South Asia. This raises a range of concerns about the use of caesarean section for non-emergency cases, not least the progressive shift of resources to non-essential medical interventions in resource-poor settings and additional health risks to mothers and newborns following a caesarean section. There are only a few studies that have systematically examined the factors influencing the recent increase in caesarean rates. In particular, it is not clear whether high elective caesarean rates are driven by medical, institutional or individual and family decisions. Where a woman's decisions predominate her interaction with peers and significant others have an impact on her caesarean section choices. Using random intercept logistic regression analyses, this paper analyses the institutional, socio-economic and community factors that influence caesarean section in six countries: Bangladesh, Colombia, Dominican Republic, Egypt, Morocco and Vietnam.

The analyses, based on data from over 20,000 births, show that women of higher socio-economic background, who had better access to antenatal services are the most likely to undergo a caesarean section. Women who exchange reproductive health information with friends and family are less likely to experience a caesarean section than their counterparts. The study concludes that there is a need to pursue community-based approaches for curbing rising caesarean section rates in resource-poor settings.

Item Type: Article
Digital Object Identifier (DOI): doi:10.1016/j.socscimed.2008.06.032
ISSNs: 0277-9536 (print)
Keywords: caesarean sections, community factors, developing countries, women, childbirth
Subjects: H Social Sciences > HA Statistics
H Social Sciences > HT Communities. Classes. Races
R Medicine > RG Gynecology and obstetrics
Divisions : University Structure - Pre August 2011 > School of Social Sciences > Social Statistics
ePrint ID: 55042
Accepted Date and Publication Date:
October 2008Published
25 July 2008Made publicly available
Date Deposited: 22 Aug 2008
Last Modified: 31 Mar 2016 12:34

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