Within country inequalities in caesarean section rates: Observational study of 72 low and middle income countries

BMJ (Online)

Volumn 360, Issue , 2018, Pages

  Boatin, Adeline Adwoa ^a   Schlotheuber, Anne ^b   Betran, Ana Pilar ^b   Moller, Ann Beth ^b   Barros, Aluisio J D ^c   Boerma, Ties ^d,e   Torloni, Maria Regina ^f   Victora, Cesar G ^c   Hosseinpoor, Ahmad Reza ^b  

^a MASSACHUSETTS GENERAL HOSPITAL   (United States)

^b WORLD HEALTH ORGANIZATION   (Switzerland)

^c FEDERAL UNIVERSITY OF PELOTAS   (Brazil)

^d Children's and Adolescents' Health ^*  (United States)

^e UNIVERSITY OF MANITOBA   (Canada)

^f FEDERAL UNIVERSITY OF SÃO PAULO   (Brazil)

Author keywords

[No Author keywords available]

Indexed keywords

ADOLESCENT; ADULT; AFRICA; ARGENTINA; ARMENIA; ARTICLE; BANGLADESH; BHUTAN; BOSNIA AND HERZEGOVINA; CAMBODIA; CESAREAN SECTION; CHAD; COLOMBIA; COMOROS; CONTROLLED STUDY; COUNTRY ECONOMIC STATUS; DEMOGRAPHY; DOMINICAN REPUBLIC; ECONOMIC ASPECT; EGYPT; ETHIOPIA; GABON; GHANA; HAITI; HEALTH CARE ACCESS; HEALTH CARE DISPARITY; HEALTH SURVEY; HONDURAS; HUMAN; INDONESIA; LIVE BIRTH; LOW INCOME COUNTRY; MALE; MATERNAL MORTALITY; MATERNAL WELFARE; MAURITIUS; MIDDLE INCOME COUNTRY; NAMIBIA; NEPAL; NEWBORN MORTALITY; NIGER; OBSERVATIONAL STUDY; OBSTETRIC PROCEDURE; PAKISTAN; PERU; PHILIPPINES; PRINCIPAL COMPONENT ANALYSIS; PRIORITY JOURNAL; RWANDA; SERBIA; SOCIAL STATUS; SOUTH SUDAN; TOGO; WESTERN HEMISPHERE; ZIMBABWE; DEVELOPING COUNTRY; MIDDLE AGED; SOCIOECONOMICS; STATISTICS AND NUMERICAL DATA; YOUNG ADULT;

ADOLESCENT; ADULT; CESAREAN SECTION; DEVELOPING COUNTRIES; HEALTHCARE DISPARITIES; HUMANS; MIDDLE AGED; SOCIOECONOMIC FACTORS; YOUNG ADULT;

EID: 85041224795     PISSN: 09598146     EISSN: 17561833     Source Type: Journal    
DOI: 10.1136/bmj.k55     Document Type: Article

References (68)

1. WHO. Maternal Health and Safe Motherhood Programme. Motherbaby package: implementing safe motherhood in countries. World Health Organization, 1996.
2. UNICEF. WHO, UNFPA. Guidelines for monitoring the availability and use of obstetric service. United Nations Children's Fund, 1997.
3. WHO. UNFPA, UNICEF, AMDD. Monitoring emergency obstetric care: a handbook. World Health Organization, 2009.
4. Ye J, Betrán AP, Guerrero Vela M, Souza JP, Zhang J. Searching for the optimal rate of medically necessary cesarean delivery. Birth 2014;41:237-44. doi:10.1111/birt.12104
5. Molina G, Weiser TG, Lipsitz SR. Relationship between cesarean delivery rate and maternal and neonatal mortality. JAMA 2015;314:2263-70. doi:10.1001/jama.2015.15553
6. Betran AP, Torloni MR, Zhang JJ, Gülmezoglu AM, WHO Working Group on Caesarean Section. WHO statement on caesarean section rates. BJOG 2016;123:667-70. doi:10.1111/1471-0528.13526
7. Dumont A, de Bernis L, Bouvier-Colle MH, Bréart G, MOMA study group. Caesarean section rate for maternal indication in sub-Saharan Africa: a systematic review. Lancet 2001;358:1328-33. doi:10.1016/S0140-6736(01)06414-5
8. Ronsmans C, Etard JF, Walraven G. Maternal mortality and access to obstetric services in West Africa. Trop Med Int Health 2003;8:940-8. doi:10.1046/j.1365-3156.2003.01111.x
9. Lumbiganon P, Laopaiboon M, Gülmezoglu AM, World Health Organization Global Survey on Maternal and Perinatal Health Research Group. Method of delivery and pregnancy outcomes in Asia: the WHO global survey on maternal and perinatal health 2007-08. Lancet 2010;375:490-9. doi:10.1016/S0140-6736(09)61870-5
10. Souza JP, Gülmezoglu A, Lumbiganon P, WHO Global Survey on Maternal and Perinatal Health Research Group. Caesarean section without medical indications is associated with an increased risk of adverse short-term maternal outcomes: the 2004-2008 WHO Global Survey on Maternal and Perinatal Health. BMC Med 2010;8:71. doi:10.1186/1741-7015-8-71
11. Lindquist SAI, Shah N, Overgaard C. Association of previous cesarean delivery with surgical complications after a hysterectomy later in life. JAMA Surg 2017;152:1148-55. doi:10.1001/jamasurg.2017.2825
12. WHO. National health inequality monitoring: a step-by-step manual. World Health Organization, 2017.
13. Betrán AP, Ye J, Moller AB, Zhang J, Gülmezoglu AM, Torloni MR. The increasing trend in caesarean section rates: global, regional and national estimates: 1990-2014. PLoS One 2016;11:e0148343. doi:10.1371/journal.pone.0148343
14. El-Khoury M, Hatt L, Gandaho T. User fee exemptions and equity in access to caesarean sections: an analysis of patient survey data in Mali. Int J Equity Health 2012;11:49. doi:10.1186/1475-9276-11-49
15. Cresswell JA, Assarag B, Meski FZ, Filippi V, Ronsmans C. Trends in health facility deliveries and caesarean sections by wealth quintile in Morocco between 1987 and 2012. Trop Med Int Health 2015;20:607-16. doi:10.1111/tmi.12466
16. Gebremedhin S. Trend and socio-demographic differentials of Caesarean section rate in Addis Ababa, Ethiopia: analysis based on Ethiopia demographic and health surveys data. Reprod Health 2014;11:14. doi:10.1186/1742-4755-11-14
17. Klemetti R, Che X, Gao Y. Cesarean section delivery among primiparous women in rural China: an emerging epidemic. Am J Obstet Gynecol 2010;202:65.e1-6. doi:10.1016/j.ajog. 2009.08.032
18. Leone T. Demand and supply factors affecting the rising overmedicalization of birth in India. Int J Gynaecol Obstet 2014;127:157-62. doi:10.1016/j.ijgo.2014.05.018
19. Prakash KC, Neupane S. Cesarean deliveries among Nepalese mothers: changes over time 2001-2011 and determinants. Arch Gynecol Obstet 2014;289:421-7. doi:10.1007/s00404-013-2976-8
20. Ronsmans C, Holtz S, Stanton C. Socioeconomic differentials in caesarean rates in developing countries: a retrospective analysis. Lancet 2006;368:1516-23. doi:10.1016/S0140-6736(06)69639-6
21. Cavallaro FL, Cresswell JA, França GV, Victora CG, Barros AJ, Ronsmans C. Trends in caesarean delivery by country and wealth quintile: cross-sectional surveys in southern Asia and sub-Saharan Africa. Bull World Health Organ 2013;91:914-922D. doi:10.2471/ BLT.13.117598
22. WHO. Global Health Observatory: Health Equity Monitor. Geneva: World Health Organization; 2016 [cited 2017 18 January]. www.who. int/gho/health-equity/en/.
23. UNICEF. Statistics and monitoring: Multiple Indicator Cluster Surveys (MICS). New York: United Nations Children's Fund; 2014 [cited 2017 18 January]. www.unicef.org/statistics/index-24302.html.
24. USAID. The DHS Program: Demographic and Health Surveys. Rockville: USAID; 2013 [cited 2017 18 January]. http://dhsprogram.com/.
25. WHO. State of inequality: reproductive, maternal, newborn and child health. World Health Organization, 2015.
26. Requejo J, Victora C, Bryce J, Scientific Review Group of Countdown to 2015. Data resource profile: countdown to 2015: maternal, newborn and child survival. Int J Epidemiol 2014;43:586-96. doi:10.1093/ ije/dyu034
27. Hancioglu A, Arnold F. Measuring coverage in MNCH: tracking progress in health for women and children using DHS and MICS household surveys. PLoS Med 2013;10:e1001391. doi:10.1371/ journal.pmed.1001391
28. Stanton CK, Dubourg D, De Brouwere V, Pujades M, Ronsmans C. Reliability of data on caesarean sections in developing countries. Bull World Health Organ 2005;83:449-55.
29. Tomeo CA, Rich-Edwards JW, Michels KB. Reproducibility and validity of maternal recall of pregnancy-related events. Epidemiology 1999;10:774-7. doi:10.1097/00001648-199911000-00022
30. USAID. The DHS Program: wealth index. Rockville: USAID; 2014 [cited 2017 18 January]. http://dhsprogram.com/topics/wealth-index/ Index.cfm.
31. World Bank. World Bank country and lending groups Washington DC: The World Bank Group; 2017 [cited 2017 30 August]. https:// datahelpdesk.worldbank.org/knowledgebase/articles/906519-world-bank-country-and-lending-groups.
32. WHO. WHO Regional Offices. Geneva: World Health Organization; 2016 [cited 2017 18 January]. www.who.int/about/regions/en/.
33. Gibbons L, Belizán JM, Lauer JA, Betrán AP, Merialdi M, Althabe F. The global numbers and costs of additionally needed and unnecessary caesarean sections performed per year: overuse as a barrier to universal coverage. World Health Report 2010, Background Paper, No 30. World Health Organization, 2010.
34. WHO. WHO statement on caesarean section rates. Geneva: World Health Organization; 2015 [cited 2017 18 January]. http://apps. who.int/iris/bitstream/10665/161442/1/WHO-RHR-15.02-eng. pdf?ua=1.
35. Betran AP, Torloni MR, Zhang J. What is the optimal rate of caesarean section at population level? A systematic review of ecologic studies. Reprod Health 2015;12:57. doi:10.1186/s12978-015-0043-6
36. Ye J, Zhang J, Mikolajczyk R, Torloni MR, Gülmezoglu AM, Betran AP. Association between rates of caesarean section and maternal and neonatal mortality in the 21st century: a worldwide population-based ecological study with longitudinal data. BJOG 2016;123:745-53. doi:10.1111/1471-0528.13592
37. World Bank. DataBank. World Development Indicators. GINI index (World Bank estimate). Washington DC: The World Bank Group; 2017 [cited 2017 20 November]. http://databank.worldbank.org/data/ reports.aspx?source=2&series=SI.POV.GINI.
38. National Cancer Institute. Health Disparities Calculator, Version 1.2.4-October 29, 2013. Bethesda; Division of Cancer Control and Population Sciences, Surveillance Research Program and Healthcare Delivery Research Program, National Cancer Institute; 2013.
39. Vogel JP, Betrán AP, Vindevoghel N, WHO Multi-Country Survey on Maternal and Newborn Health Research Network. Use of the Robson classification to assess caesarean section trends in 21 countries: a secondary analysis of two WHO multicountry surveys. Lancet Glob Health 2015;3:e260-70. doi:10.1016/S2214-109X(15)70094-X
40. Ortiz I, Cummins M. Global Inequality: Beyond the bottom billion-A rapid review of income distribution in 141 countries. UNICEF Social and Economic Policy Working Paper. New York: United Nations Children's Fund; 2011.
41. Holmer H, Lantz A, Kunjumen T. Global distribution of surgeons, anaesthesiologists, and obstetricians. Lancet Glob Health 2015;3(Suppl 2):S9-11. doi:10.1016/S2214-109X(14)70349-3
42. Ologunde R, Vogel JP, Cherian MN, Sbaiti M, Merialdi M, Yeats J. Assessment of cesarean delivery availability in 26 low-and middle-income countries: a cross-sectional study. Am J Obstet Gynecol 2014;211:504.e1-12.
43. Say L, Raine R. A systematic review of inequalities in the use of maternal health care in developing countries: examining the scale of the problem and the importance of context. Bull World Health Organ 2007;85:812-9. doi:10.2471/BLT.06.035659
44. Chigbu CO, Iloabachie GC. The burden of caesarean section refusal in a developing country setting. BJOG 2007;114:1261-5. doi:10.1111/ j.1471-0528.2007.01440.x
45. Edmonds JK, Cwiertniewicz T, Stoll K. Childbirth education prior to pregnancy? Survey findings of childbirth preferences and attitudes among young women. J Perinat Educ 2015;24:93-101. doi:10.1891/1058-1243.24.2.93
46. Torloni MR, Betrán AP, Montilla P. Do Italian women prefer cesarean section? Results from a survey on mode of delivery preferences. BMC Pregnancy Childbirth 2013;13:78. doi:10.1186/1471-2393-13-78
47. Mi J, Liu F. Rate of caesarean section is alarming in China. Lancet 2014;383:1463-4. doi:10.1016/S0140-6736(14)60716-9
48. Mazzoni A, Althabe F, Gutierrez L. Women's preferences and mode of delivery in public and private hospitals: a prospective cohort study. BMC Pregnancy Childbirth 2016;16:34. doi:10.1186/ s12884-016-0824-0
49. Torloni MR, Daher S, Betrán AP. Portrayal of caesarean section in Brazilian women's magazines: 20 year review. BMJ 2011;342:d276. doi:10.1136/bmj.d276
50. Rahnama P, Mohammadi K, Montazeri A. Salient beliefs towards vaginal delivery in pregnant women: A qualitative study from Iran. Reprod Health 2016;13:7. doi:10.1186/s12978-016-0120-5
51. Allin S, Baker M, Isabelle M, Stabile M. Physician incentives and the rise in c-sections: evidence from Canada. NBER Working Paper No 21022. Cambridge: National Bureau of Economic Research; 2015.
52. Roy A, Shengelia L. An analysis on maternal healthcare situation in Bangladesh: a review. Divers Equal Health Care 2016;13:360-4.
53. Ministry of Health and Family Welfare. Health Bulletin 2013. Government of the People's Republic of Bangladesh, Directorate General of Health Services, 2014.
54. Dingle A, Powell-Jackson T, Goodman C. A decade of improvements in equity of access to reproductive and maternal health services in Cambodia, 2000-2010. Int J Equity Health 2013;12:51. doi:10.1186/1475-9276-12-51
55. Ministry of Health. National Health Strategic Plan 2008-2015. Royal Government of Cambodia, 2008.
56. Ministry of Health. Fast Track Initiative Road Map for Reducing Maternal and Neonatal Mortality 2010-2015. Royal Government of Cambodia, 2010.
57. Royal Government of Cambodia. National Social Protection Strategy for the Poor and Vulnerable. Royal Government of Cambodia, 2011.
58. Witter S, Adjei S, Armar-Klemesu M, Graham W. Providing free maternal health care: ten lessons from an evaluation of the national delivery exemption policy in Ghana. Glob Health Action 2009;2:2. doi:10.3402/gha.v2i0.1881
59. Adua E, Frimpong K, Li X, Wang W. Emerging issues in public health: a perspective on Ghana's healthcare expenditure, policies and outcomes. EPMA J 2017;8:197-206. doi:10.1007/s13167-017-0109-3
60. Brooks MI, Thabrany H, Fox MP, Wirtz VJ, Feeley FG, Sabin LL. Health facility and skilled birth deliveries among poor women with Jamkesmas health insurance in Indonesia: a mixed-methods study. BMC Health Serv Res 2017;17:105. doi:10.1186/s12913-017-2028-3
61. Worley H. Rwanda's Success In Improving Maternal Health Washington DC: Population Reference Bureau; 2015 [cited 2017 20 November]. www.prb.org/Publications/Articles/2015/rwandamaternal-health.aspx.
62. Farmer PE, Nutt CT, Wagner CM. Reduced premature mortality in Rwanda: lessons from success. BMJ 2013;346:f65. doi:10.1136/ bmj.f65
63. Betrán AP, Vindevoghel N, Souza JP, Gülmezoglu AM, Torloni MR. A systematic review of the Robson classification for caesarean section: what works, doesn't work and how to improve it. PLoS One 2014;9:e97769. doi:10.1371/journal.pone.0097769
64. Ronsmans C, De Brouwere V, Dubourg D, Dieltiens G. Measuring the need for life-saving obstetric surgery in developing countries. BJOG 2004;111:1027-30. doi:10.1111/j.1471-0528.2004.00247.x
65. FIGO Working Group On Challenges In Care Of Mothers And Infants During Labour And Delivery. Best practice advice on the 10-Group Classification System for cesarean deliveries. Int J Gynaecol Obstet 2016;135:232-3. doi:10.1016/j.ijgo.2016.08.001
66. Boatin AA, Cullinane F, Torloni MR, Betran AP. Audit and feedback using the Robson classification to reduce caesarean section rates: a systematic review. BJOG 2017.
67. Torloni MR, Betran AP, Souza JP. Classifications for cesarean section: a systematic review. PLoS One 2011;6:e14566. doi:10.1371/journal. pone.0014566
68. Speybroeck N, Konings P, Lynch J. Decomposing socioeconomic health inequalities. Int J Public Health 2010;55:347-51. doi:10.1007/s00038-009-0105-z