The role of demographic and socioeconomic factors, leave policy and government institutions in CS deliveries in Ghana

• Published in: Journal of public health Vol. 25; no. 5; pp. 557 - 564
• Main Authors: Owoo, Nkechi S., Lambon-Quayefio, Monica Puoma, Onuoha, Nicole Amara
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.10.2017; Springer Nature B.V
• Subjects: Demographics; Economic factors; Epidemiology; Health care delivery; Health care facilities; Health Promotion and Disease Prevention; Institutions; Medicine; Medicine & Public Health; Mortality; Neonates; Original Article; Pregnancy; Pregnancy complications; Public Health; Social factors; Socioeconomic factors; Socioeconomics; Ghana; Maternity leave; Caesarean section; Ghana; Demographic and health survey; Government health institution
• ISSN: 2198-1833; 1613-2238
• DOI: 10.1007/s10389-017-0816-1

Aim Caesarean section deliveries in Ghana increased from 6 to 13% between 2008 and 2014. This current rate is dangerously close to the safe limit suggested by the World Health Organisation (WHO) and is particularly concerning in the absence of a negative correlation between the rising CS rates and neonatal mortality in the country. The research therefore examines the factors correlated with caesarean section delivery in Ghana, with an aim to making research-based policy suggestions to curb the observed trends. Subjects and methods The 2014 Ghana Demographic and Health Survey is employed for the analysis, and a probit model is used to examine the effects of demographic and socioeconomic factors, maternal leave policy and government health institutions on the likelihood of caesarean section deliveries in Ghana. The analysis uses the last births of 1284 women of childbearing age in the country. Results The results indicate that demographic and socioeconomic factors are important determinants of caesarean section deliveries. While antenatal care attendance at government institutions reduces the likelihood of caesarean section, deliveries in government health facilities are more likely to be done by caesarean section. Interestingly, women with previous pregnancy complications are not significantly more likely to have a caesarean section delivery. This might indicate that many caesarean sections performed in the country may be elective and not necessarily medically necessary. Conclusions Child and maternal survivals are often given as justifications for caesarean section deliveries. The absence of a negative relationship between increasing caesarean section rates and neonatal mortality in the country therefore creates some concern.