Department of Population and Health, University of Cape Coast, Cape Coast, Ghana.
Department of Health, Physical Education and Recreation, University of Cape Coast, Cape Coast, Ghana.
BMC Pregnancy Childbirth. 2020 Feb 18;20(1):114. doi: 10.1186/s12884-020-2792-7.
The increasing rate of caesarean deliveries (CD) has become a serious concern for public health experts globally. Despite this health concern, research on factors associated CD in many low- and -middle countries like Ghana is sparse. This study, therefore, assessed the prevalence and determinants of CD among child-bearing women aged 15-49 in Ghana.
The study used data from the 2014 Ghana Demographic and Health Survey. The analysis was limited to mothers (n = 2742) aged 15-49 , who had given birth in health facilities 5 years preceding the survey. Association between CD and its determinants was assessed by calculating adjusted odds ratios (AOR) with their respective 95% confidence intervals using a binary logistic regression.
The percentage of mothers who delivered their babies through caesarean section (CS) was 18.5%. Using multivariable logistic regression, the results showed that women aged 45-49 (AOR = 10.5; 95% CI: 3.0-37.4), and women from a household that are headed by a female (AOR = 1.3; 95% CI = 1.1-1.7) had higher odds to deliver through CS. Women from the Upper East (AOR =0.4; 95% CI = 0.2-0.7) and Upper West (AOR = 0.4; 95% CI = 0.2-0.8) regions had lower odds to deliver their children through CS. Women with parity 4 or more (AOR = 0.3; 95% CI = 0.2-0.5) had lower odds of CD compared to those with parity 1. Women with female babies had lower odds (AOR = 0.8; CI = 0.7-0.9) of delivering them through CS compared to those with male children.
The percentage of women delivering babies through the CS in Ghana is high. The high rates of CD noted do not essentially indicate good quality care or services. Hence, health facilities offering this medical protocol need to adopt comprehensive and strict measures to ensure detailed medical justifications by doctors for performing these caesarean surgeries.
剖宫产率的上升已成为全球公共卫生专家关注的严重问题。尽管存在这种健康担忧，但在加纳等许多低收入和中等收入国家，有关剖宫产相关因素的研究仍然很少。因此，本研究评估了加纳 15-49 岁育龄妇女的剖宫产率及其决定因素。
本研究使用了 2014 年加纳人口与健康调查的数据。分析仅限于在调查前 5 年内在卫生机构分娩的 15-49 岁母亲（n=2742）。使用二元逻辑回归计算调整后的优势比（AOR）及其各自的 95%置信区间来评估剖宫产率及其决定因素之间的关联。
经剖宫产分娩的母亲比例为 18.5%。使用多变量逻辑回归，结果表明，45-49 岁的妇女（AOR=10.5；95%CI：3.0-37.4）和由女性领导的家庭的妇女（AOR=1.3；95%CI：1.1-1.7）更有可能通过剖宫产分娩。来自上东部（AOR=0.4；95%CI：0.2-0.7）和上西部（AOR=0.4；95%CI：0.2-0.8）地区的妇女通过剖宫产分娩的几率较低。产次为 4 次或以上的妇女（AOR=0.3；95%CI：0.2-0.5）比产次为 1 次的妇女剖宫产的几率较低。分娩女婴的妇女通过剖宫产分娩的几率较低（AOR=0.8；CI=0.7-0.9），与分娩男婴的妇女相比。
在加纳，通过剖宫产分娩的妇女比例较高。剖宫产率高并不一定表明医疗质量或服务良好。因此，提供这种医疗方案的卫生机构需要采取全面和严格的措施，确保医生详细说明进行这些剖宫产手术的医学依据。
