Statistics Discipline, Science, Engineering and Technology School, Khulna University, Khulna, 9208, Bangladesh.
Sociology Discipline, Social Science School, Khulna University, Khulna, 9208, Bangladesh.
Sci Rep. 2022 Apr 1;12(1):5554. doi: 10.1038/s41598-022-09567-1.
Caesarean delivery (C-section) has been increasing worldwide; however, many women from developing countries in Sub-Saharan Africa are deprived of these lifesaving services. This study aimed to explore the impact of certain socioeconomic factors, including respondent's education, husband's education, place of residence, and wealth index, on C-section delivery for women in Sub-Saharan Africa. We used pooled data from 36 demographic and health surveys (DHS) in Sub-Saharan Africa. Married women aged 15-49 years who have at least one child in the last five years were considered in this survey. After inclusion and excluding criteria, 234,660 participants were eligible for final analysis. Binary logistic regression was executed to determine the effects of selected socioeconomic factors. The countries were assembled into four sub-regions (Southern Africa, West Africa, East Africa, and Central Africa), and a meta-analysis was conducted. We performed random-effects model estimation for meta-analysis to assess the overall effects and consistency between covariates and utilization of C-section delivery as substantial heterogeneity was identified (I > 50%). Furthermore, the meta-regression was carried out to explain the additional amount of heterogeneity by country levels. We performed a sensitivity analysis to examine the effects of outliers in this study. Findings suggest that less than 15% of women in many Sub-Saharan African countries had C-section delivery. Maternal education (OR 4.12; CI 3.75, 4.51), wealth index (OR 2.05; CI 1.94, 2.17), paternal education (OR 1.71; CI 1.57, 1.86), and place of residence (OR 1.51; CI 1.44, 1.58) were significantly associated with the utilization of C-section delivery. These results were also consistent in sub-regional meta-analyses. The meta-regression suggests that the total percentage of births attended by skilled health staff (TPBASHS) has a significant inverse association with C-section utilization regarding educational attainment (respondent & husband), place of residence, and wealth index. The data structure was restricted to define the distinction between elective and emergency c-sections. It is essential to provide an appropriate lifesaving mechanism, such as C-section delivery opportunities, through proper facilities for rural, uneducated, impoverished Sub-Saharan African women to minimize both maternal and infant mortality.
剖宫产(C -section)在全球范围内呈上升趋势;然而,撒哈拉以南非洲的许多发展中国家的妇女却无法获得这些救命的服务。本研究旨在探讨某些社会经济因素,包括受访者的教育程度、丈夫的教育程度、居住地和财富指数,对撒哈拉以南非洲妇女剖宫产的影响。我们使用了来自撒哈拉以南非洲的 36 项人口与健康调查(DHS)的汇总数据。这项调查考虑了过去五年中有至少一个孩子的 15-49 岁已婚妇女。在纳入和排除标准后,有 234660 名参与者符合最终分析条件。采用二元逻辑回归分析确定选定社会经济因素的影响。将各国分为四个次区域(南部非洲、西非、东非和中非),并进行了荟萃分析。我们采用随机效应模型估计进行荟萃分析,以评估整体效果和协变量之间的一致性,因为发现了大量异质性(I>50%)。此外,还进行了元回归分析,以解释国家层面上差异的额外量。我们进行了敏感性分析,以检查本研究中异常值的影响。研究结果表明,在许多撒哈拉以南非洲国家,不到 15%的妇女接受了剖宫产。母亲的教育程度(OR 4.12;95%CI 3.75,4.51)、财富指数(OR 2.05;95%CI 1.94,2.17)、父亲的教育程度(OR 1.71;95%CI 1.57,1.86)和居住地(OR 1.51;95%CI 1.44,1.58)与剖宫产的利用显著相关。这些结果在次区域荟萃分析中也是一致的。元回归分析表明,熟练卫生人员接生的总比例(TPBASHS)与教育程度(受访者和丈夫)、居住地和财富指数与剖宫产利用之间呈显著负相关。数据结构受到限制,无法明确区分选择性和紧急剖宫产。为撒哈拉以南非洲农村、未受教育、贫困的妇女提供适当的救命机制,例如剖宫产机会,对于降低母婴死亡率至关重要。
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