Observed trends in the magnitude of socioeconomic and area-based inequalities in use of caesarean section in Ethiopia: a cross-sectional study

BMC Public Health

Gebretsadik Shibre¹  Dina Idriss-Wheeler²  Sanni Yaya³  Ghose Bishwajit³ 

[1] Department of Reproductive Health and Health Services Management, School of Public Health, Addis Ababa University;Interdisciplinary School of Health Sciences, Faculty of Health Sciences, University of Ottawa;School of International Development and Global Studies, Faculty of Social Sciences, University of Ottawa;

关键词: Caesarean section;    Inequality;    Global health;    Ethiopia;    DHS;   

DOI  :  10.1186/s12889-020-09297-x

来源: DOAJ

【 摘 要 】

Abstract Background In Ethiopia, there is a paucity of studies on inequality in caesarean section using methodologically rigorous and well-established approaches. In this study, we showed extent and the overtime dynamics of inequality in caesarean section in Ethiopia following rigorous methodologies. Methods The data for analysis came from Ethiopia Demographic and Health Surveys (EDHS) conducted between 2000 and 2016. We used the World Health Organization’s (WHO) Health Equity Assessment Toolkit (HEAT) to analyze the data. Caesarean delivery was disaggregated by four equity stratifiers, namely education, wealth, residence and regions. Relative and absolute summary measures were calculated for each equity stratifier to capture inequality from different perspectives. 95% Uncertainty Interval was calculated around a point estimate to measure statistical significance. Results We found large socioeconomic and area-based inequalities in use of caesarean section in all study surveys. The inequalities have occurred in favour of socioeconomically advantaged women and those living in urban areas and certain regions such as Addis Ababa. While area-related inequality had generally increased with time, socioeconomic inequality showed fluctuation. Adoption of different measures in the study for the inequality analysis has caused the emergence of mix of patterns in caesarean section inequality over time. Conclusions In all the surveys, wealthy and more educated women, and those residing in urban areas had higher chance of obtaining caesarean delivery. Policy makers should work to ensure caesarean section that is in the accepted normal range. More emphasis should be drawn to subpopulation with under use of caesarean section while at the same time, discouraging unjustified use of it.

【 授权许可】

Unknown