Prevalence Of Caesarean Section And The Associated Factors In Private Hospitals In Addis Ababa - A Cross-sectional Study

Background: Caesarean delivery has been increasing at an alarming rate globally. This increasernhas become a major challenge across health institutions in both developed and developingrncountries. Caesarean delivery rate has been shown to be more common in the private fee–for–rnservice hospitals than public hospitals. The Ethiopia Demographic and health survey reported anrnincrease in the caesarean delivery rate between 2005 and 2011 from 16% to 21.8% and even arnhigher rate among women who delivered in private health institutions (41.7%) which was twicernhigher than their counterparts who delivered in public institutions (20.6%) signifying thernpossibility of over-utilization of the service in the private hospital.rnObjective: To determine the prevalence of Caesarean delivery and the associated factors inrnprivate hospital in Addis Ababa.rnMethod: This study was a facility based cross-sectional survey carried out in private hospitals inrnAddis Ababa during the months of April to May 2017. Study participants were selected usingrnmulti-stage random sampling technique. Four hundred and eleven consecutive delivered mothersrnwho consented from the selected private hospitals providing basic and comprehensive obstetricsrnservices participated in study. A pre-tested structured questionnaire was used to obtainrninformation from the respondents. Data was entered in Epi Info version 7 and exported tornSTATA version 12 for analysis. Multivariable analysis was carried out. Strength of associationsrnand significance level was examined using odds ratio and 95% confidence intervals respectively.rnResult: The prevalence of Caesarean delivery in private hospitals in Addis Ababa was 63.7% [CIrn(59.1%, 68.3%)]. Being primiparous [AOR=2.89, 95% CI (1.19, 6.98)], multiparousrn[AOR=10.2, 95% CI (4.13, 25.4)], previous Caesarean delivery [AOR=12.48, 95% CI (6.01,rn25.95)] and having health insurance coverage were found to be positive and statisticallyrnsignificantly associated with having Caesarean delivery.rnConclusion: Limiting primary Caesarean delivery to the barest minimum by only performingrnsuch for only absolute indications, allowing vaginal birth after Caesarean section (VBAC)rnthrough close monitoring during labour, counselling of parturient at the antenatal clinics onrnpossibility of VBAC and the risks associated with unnecessary request for Caesarean sectionrnwould be important to decrease the high prevalence of CS.

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