Correlates of caesarean delivery in Uganda

Abstract

The increasing rate of caesarean deliveries has become a serious concern for public health experts globally. Various medical and non-medical factors are found to be responsible for this upsurge. Like in other countries, caesarean delivery rates increased both at facility and population levels in Uganda. Overall, the caesarean section rate for live births at facilities was 10%, increasing from 9% in 2012 to 11% in 2016. The overall population-based caesarean section rate was 5%, and increased from 3% to 7% over the same period. There is therefore need to investigate the factors behind this and hence this study aimed to examine the correlates of caesarean section delivery in Uganda. We conducted secondary analysis of data from a sample of 10,117 women from the Uganda Demographic Health Survey 2016. Data about the method of last birth was collected in dichotomous form as either caesarean section or otherwise. We used frequency distributions for description, chi-square tests for initial associations, and multivariable complementary log log regressions to assess the associations. About 7% of the women aged 15-49 years reported caesarean delivery. Caesarean delivery was associated with advancement in age (OR=2.03; 95% CI: 1.13-3.65), lower birth order (OR=0.47, 95% CI: 0.34-0.65), lower parity (OR=0.65, 95% CI: 0.47-0.88), higher education level (OR=2.10, 95% CI: 1.32-3.34), higher wealth quintile (OR=3.12, 95% CI: 2.18-4.45). Caesarean delivery is associated with selected demographic and socio-economic factors. Therefore, there is an urgent need to provide women and care providers with information on the risks associated with caesarean delivery.