scholarly journals Too many yet too few caesarean section deliveries in Bangladesh: an ongoing public health challenge to improve maternal and child health

2021 ◽  
Author(s):  
Md Nuruzzaman Khan ◽  
Md Awal Kabir ◽  
Asma Ahmad Shariff ◽  
Md Mostafizur Rahman
Keyword(s):  
Caesarean Section ◽  
Rural Women ◽  
Maternal Education ◽  
Economic Condition ◽  
Wealth Quintile ◽  
Health Facilities ◽  
Outcome Variable ◽  
Place Of Residence ◽  
Double Burden ◽  
The Government

AbstractBackgroundCaesarean section (CS) use is on the rise in Bangladesh, particularly among women in improved socio-economic condition. However, the deficit use of CS remains common among disadvantage women in terms of employment, education, wealth quintile, and place of residence. This increases risks of long-term obstetric complications as well as maternal and child deaths. We aimed to determine the interaction effects of women’s disadvantage characteristics on CS use in Bangladesh.MethodsTotal of 27,093 women data analysed extracted from five rounds of Bangladesh Demographic and Health Survey, conducted between 2004 and 2017/18. The inclusion criteria used to select these women were: (i) having at least one child within three prior to the survey, (ii) reported delivery methods and place, and (iii) do not have twin or more ordered pregnancy for the most recent live birth. The major exposure variables were type of health facilities, divisions, place of residence, economic status, and maternal education. Other factors considered were factors at the individual and household level. The outcome variable was CS use, coded as use (1) and non-use (0). Multilevel logistic regression model was used to determine association of CS with socio-demographic characteristics and the interactions of the working status and wealth quintile with place of residence.ResultsWe reported a 751% increase of CS use over the last 13 years — from 3.88% in 2004 to 33% in 2017/18. Nearly, 80% of these occurred in the private health facilities followed by the government health facilities (15%). Rural women with no engagement of formal income generating activity showed 11% (OR, 0.89, 95% CI, 0.71-0.99) lower use of CS in 2004. This association was further strengthened with the year passes, and a 51% (OR, 0.49, 0.03-0.65) lower in CS use was reported in 2017/18. Similarly, around 12%-83% lower likelihoods of CS use were found among rural poor and poorer women.ConclusionBangladesh is facing a double burden of CS, that is a group of women with improved socio-economic condition using this life saving procedure without medical necessity while their counterpart of disadvantage characteristics could not access this service. Improved monitoring from the government along with support to use CS services for the disadvantage groups on necessity are important.

scholarly journals Correlate of Post-natal care utilization in rural Ethiopia: An evidence from Secondary data analysis of Ethiopian Demographic Health survey 2016.

2019 ◽  
Author(s):  
REKIKU Fikre Abebe ◽  
Berhan Tsegaye Negash ◽  
Zelalem Tenaw bogale ◽  
wegene Jemebere Beru ◽  
Getnet Kassahun Molla
Keyword(s):  
Health Survey ◽  
Rural Women ◽  
Postnatal Care ◽  
Wealth Quintile ◽  
Outcome Variable ◽  
Care Utilization ◽  
Demographic Health Survey ◽  
Place Of Delivery ◽  
The Past ◽  
The Government

Abstract Abstract Background: Postnatalcareutilizationis the most neglected care in Ethiopian,despite a large proportion of maternal and neonatal deaths occurs during postnatal period. Evidence suggested that utilization of postnatal care averts major complications of the fetus and mother.But,proportion of rular women utilization of postnatal care is low in Ethiopia. Information about prevalence and factors which determine utilization of postnatal care utlization in rular women in Ethiopia is mandatory for policy making, and program design to enhance its utilization. Objective: Theobjective of this study was to determine the prevalence of utilization of postnatal care and to identify its determinant factorsamong rural women who gave birth in the past five yearsbefore Ethiopian demographic health survey, in 2016. Method: This study utilized data from Ethiopian demographic health survey2016 for analysis. It is a national two stage, cross sectional study. It analyzed data for rural women who gave birth at least one time in the past five year before data survey time. Logistic regression was applied to identify explanatory variables associated with outcome variable. Adjusted odds ratio with 95% confidence interval was computed and P-value< 0.05 was considered as statistically significant. Result:The prevalenceof postnatal care utilizationamong rural women was 11.4%.Place of delivery[AOR=4.3, 95%CI, 1.4-5.2], ANCvisit [AOR=2.1, 95%CI, 1.1-3.9] and Women in the richest wealth quintile [AOR=2.97, 95%CI, 1.9-4.5] were factors associated with postnatal care service utilization among rural women in Ethiopia in 2016. Conclusion and recommendation: This study showed that prevalence of postnatal care utlization was low. Being in richest wealth quintile, history of ANC vist and place of delivery were positive predictors of postnatal care utlization among rural women. Regardless of proven strategies utilized to maximize utilization of postnatal care utlization by the government of Ethiopia, this study showed that prevalence is low in rural areas. Therefore, community awareness creation, increasing institutional coverage by expanding maternity waiting area and besides, the government should design and implement income increasing package among rural women.

scholarly journals Levels, trends and socio-economic correlates of caesarean section deliveries

2019 ◽  
Vol 33 (4) ◽  
pp. 323-335
Author(s):  
Javeed A. Golandaj ◽  
Jyoti S. Hallad
Keyword(s):  
Caesarean Section ◽  
Maternal Education ◽  
State Level ◽  
Household Survey ◽  
Poverty Line ◽  
Health Facilities ◽  
Content Type ◽  
Logistic Regression Models ◽  
Surgical Tool ◽  
Life Saving

Purpose Caesarean section (CS) is being used as a life-saving surgical tool when complications arise in the process of childbirth. CS rates have dramatically increased across the world, especially in recent decades. In this background, the purpose of this paper is to explore the CS rates and its determinants in Karnataka, India. Design/methodology/approach The study uses multiple rounds of the District Level Household Survey (DLHS) data to show the trends, differentials and determinants in CS deliveries. Both bivariate and multivariate analyses have been carried out, and the χ2 test and logistic regression models were applied. Findings Result shows a sharp increase in CS rates across Karnataka; further, this is high and reaches an alarming level in southern parts of the state. Along with a huge rural–urban difference, significant biological and socio-economic differences were observed. Further, a very dramatic increase in the CS rate was observed in private health facilities, whereas it was stagnant or even decreased in public health facilities during recent years. Mothers age at birth, birth weight, birth order, multiple births, birth institution and place of residence were significantly associated with CS delivery. Unlike these biological factors, the social-economic factors like maternal education, caste, religion and below poverty line household were not found to be significant in determining CS deliveries. Originality/value A strong policy to address the dramatic increase in CS deliveries is the need of the hour. Further, there should be a proper mechanism at national, state and sub-state level to provide appropriate checks and monitoring for CS deliveries which are unnecessary.

scholarly journals Understanding the determinants of postnatal care uptake for babies: A mixed effects multilevel modelling of 2016–18 Papua New Guinea Demographic and Health Survey

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Francis Appiah ◽  
Justice Ofosu Darko Fenteng ◽  
Felix Dare ◽  
Tarif Salihu ◽  
Andrews Ohene Darteh ◽  
...  
Keyword(s):  
Socioeconomic Status ◽  
Papua New Guinea ◽  
Health Survey ◽  
Postnatal Care ◽  
Maternal Education ◽  
New Guinea ◽  
Wealth Quintile ◽  
Demographic And Health Survey ◽  
World Health ◽  
Outcome Variable

Abstract Background Papua New Guinea (PNG) recorded 22 neonatal deaths out of every 1,000 livebirths in 2019. Some of these deaths are related to complications that arise shortly after childbirth; hence, postnatal care (PNC) utilisation could serve as a surviving strategy for neonates as recommended by the World Health Organisation. National level study on determinants of PNC uptake in PNG is limited. Utilising the Bronfenbrenner’s Ecological Model of Human Development, the study aimed at assessing determinants of PNC utilisation for babies by their mothers aged 15–49 in PNG. Methods The study used data from the women’s file of the 2016–18 PNG Demographic and Health Survey (2016–18 PNGDHS) and a sample of 4,908 women aged 15–49 who had complete information on the variables of interest to the study. Nineteen (19) explanatory variables were selected for the study whereas PNC for babies within first two months after being discharged after birth was the main outcome variable. At 95% confidence interval (95% CI), six multilevel logistic models were built. The Akaike Information Criterion (AIC) was used to assess models’ fit. All analyses were carried out using STATA version 14.0. Results Generally, 31% of the women utilised PNC for their babies. Women with primary education [aOR = 1.42, CI = 1.13–1.78], those belonging to the middle wealth quintile [aOR = 1.42, CI = 1.08–1.87], working class [aOR = 1.28, CI = 1.10–1.49], women who had the four or more ANC visits [aOR = 1.23, CI = 1.05–1.43], those with twins [aOR = 1.83, CI = 1.01–3.29], women who belonged to community of medium literate class [aOR = 1.75, CI = 1.34–2.27] and those of moderate socioeconomic status [aOR = 1.60, CI = 1.16–2.21] had higher odds of seeking PNC for their babies. The odds to seek PNC services for babies reduced among the cohabiting women [aOR = 0.79, CI = 0.64–0.96], those at parity four or more [aOR = 0.77, CI = 0.63–0.93], women who gave birth to small babies [aOR = 0.80, CI = 0.67–0.98] and residents in the Highlands region [aOR = 0.47, CI = 0.36–0.62]. Conclusions Maternal education, wealth quintile, occupation, partner’s education, ANC visits, marital status, parity, child size at birth, twin status, community literacy and socioeconomic status as well as region of residence were associated with PNC uptake for babies in PNG. Variation in PNC uptake for babies existed from one community/cluster to the other. There is the need to strengthen public health education to increase awareness about the benefits of seeking PNC services for babies among women in PNG. Such programs should consider maternal and community/cluster characteristics in their design.

scholarly journals Study of sociodemographic factors of women undergoing caesarean section in tertiary care centre of rural area of central India

2019 ◽  
Vol 8 (12) ◽  
pp. 4757
Author(s):  
Shuchi M. Jain ◽  
Ketki Thool ◽  
Poonam V. Shivkumar ◽  
Manish A. Jain
Keyword(s):  
Caesarean Section ◽  
Rural Women ◽  
Caesarean Section Rate ◽  
Health Centre ◽  
Tertiary Care ◽  
Central India ◽  
Demographic Characteristics ◽  
Health Facilities ◽  
Population Characteristics ◽  
Tertiary Care Centre

Background: Many studies have attempted to examine and evaluate the changes in population characteristics that may have contributed to the observed increase in CS rate. The aim of this study was to determine the caesarean section rate and demographic characteristics of women undergoing caesarean section in our rural tertiary health centre of central India.Methods: This prospective study was conducted in department of obstetrics and gynecology. The study instrument comprised a pre-structured data collection proforma which had various sections; social demographic characteristics, obstetric history and gestation details.Results: The overall caesarean section rate (CSR) was 36.88%. Maximum women (39.62%) who underwent Caesarean section were of age group 25-29 years. 58.05% from rural while 41.95% from urban area. CS was more in women of lower middle (22.80%) and upper lower (20.80%) class. Majority of women who had caesarean section were educated till higher school (31.87%) or were graduate (22.61%), 5.85% were illiterate. Majority of women (56.40%) were housewives. CSR was 70.83% in referred and 28.31% in booked. 52.86% women were nulliparous. Caesarean section was maximum (83%) in term, 16.92% preterm women and 0.08% post term women. 38.69% were referred from other health facilities. Maximum referrals 43.21% were from the district hospital.Conclusions: It was noted that the preference for caesarean section is more in women of 25-29 years, lower middle and upper middle class, rural women, educated upto high school and housewives at our centre. This hospital also serves as referral centre from surrounding health facilities increasing the caesarean section rate of the institute.

scholarly journals What Influences Where They Give Birth? Determinants of Place of Delivery among Women in Rural Ghana

2016 ◽  
Vol 2016 ◽  
pp. 1-8 ◽  
Author(s):  
Kwamena Sekyi Dickson ◽  
Kenneth Setorwu Adde ◽  
Hubert Amu
Keyword(s):  
Health Facility ◽  
Rural Women ◽  
Rural Areas ◽  
Maternal Education ◽  
Wealth Quintile ◽  
Empirical Literature ◽  
Ecological Zone ◽  
Wealth Status ◽  
Place Of Delivery ◽  
Rural Ghana

Background. There is a paucity of empirical literature in Ghana on rural areas and their utilisation of health facilities. The study examined the effects of the sociodemographics of rural women on place of delivery in the country. Methods. The paper made use of data from the 2014 Ghana Demographic and Health Survey. Women from rural areas who had given birth within five years prior to the survey were included in the analysis. Descriptive analyses and binary logistic regression were used to analyse the data. Results. Wealth, maternal education, ecological zone, getting money for treatment, ethnicity, partner’s education, parity, and distance to a health facility were found as the determinants of place of delivery among women in rural Ghana. Women in the richest wealth quintile were three times (OR = 3.04, 95% CI = 0.35–26.4) more likely to deliver at a health facility than the poorest women. Conclusions. It behoves the relevant stakeholders including the Ghana Health Service and the Ministry of Health to pay attention to the wealth status, maternal education, ecological zone, ethnicity, partner’s education, parity, and distance in their planning regarding delivery care in rural Ghana.

scholarly journals The Association between Ethnicity and Level of Education with Exclusive Breastfeeding Practice in the Context of the Place of Residence in Nigeria

2020 ◽  
Author(s):  
Nkemdilim P Anazonwu ◽  
Chukwuedozie K Ajaero ◽  
Peter O Mbah
Keyword(s):  
Exclusive Breastfeeding ◽  
Rural Women ◽  
Rural Areas ◽  
Urban Areas ◽  
Binary Logistic Regression ◽  
Outcome Variable ◽  
Place Of Residence ◽  
Chi Square ◽  
Level Of Education ◽  
Urban And Rural Areas

Abstract BackgroundWhile researches have been done separately on ethnicity and level of education as factors of exclusive breastfeeding (EBF) practice, there is dearth of studies on the peculiarities of EBF practice in the context place of residence as regards to the combined influence of ethnicity and level of education. To examine the association of ethnicity and level of education with exclusive breastfeeding (EBF) practice in urban and rural areas of Nigeria.MethodsData was from the Nigeria Demographic and Health Survey (NDHS) of 2018. The sample comprised of 16,982 urban and 24,834 rural women aged 15-49 years in all the 36 States and the Federal Capital Territory (FCT) of Nigeria. The outcome variable was exclusive breast-feeding (EBF) practice while the major predictor variables were ethnicity and level of education. Analyses of data were by descriptive statistics, Pearson Chi square and binary logistic regression at 0.05 level of significance. ResultsHigher education levels were significantly associated with decreased engagement in EBF practice in urban and rural areas while ethnic differences were significantly associated with EBF practice in the rural areas. Being aged 25-34 years (OR=2.316; p=0.000) was significantly associated with increased odds of EBF practice in urban areas. Moreover, region of residence was significantly associated with EBF practice in the rural areas. Finally, in both rural and urban areas, households with more than two children were significantly associated with increased odds of EBF.ConclusionsMore sensitization campaigns on the need to incorporate EBF practice into formal employment work ethics where women with higher levels of education mostly work are needed in urban areas. In addition, ethnic practices, which promote EBF practices, should be encouraged in antenatal and postnatal clinics.

Some aspects of the idea of unity V. Solovyov and the present

2000 ◽  
pp. 20-25
Author(s):  
O. O. Romanovsky
Keyword(s):  
Nineteenth Century ◽  
National Policy ◽  
The State ◽  
Place Of Residence ◽  
The Government ◽  
The University ◽  
Temporary Closure

In the second half of the nineteenth century, the nature of the national policy of Russia is significantly changing. After the events of 1863 in Poland (the Second Polish uprising), the government of Alexander II gradually abandoned the dominant idea of ​​anathematizing, whose essence is expressed in the domination of the principle of serving the state, the greatness of the empire. The tsar-reformer deliberately changes the policy of etatamism into the policy of state ethnocentrism. The manifestation of such a change is a ban on teaching in Polish (1869) and the temporary closure of the University of Warsaw. At the end of the 60s, the state's policy towards a five million Russian Jewry was radically revised. The process of abolition of restrictions on travel, education, place of residence initiated by Nicholas I, was provided reverse.

FACTORS INFLUENCING ENTREPRENEURIAL SUCCESS AMONG THE RURAL WOMEN ENTREPRENEURS IN BANGLADESH

2020 ◽  
Author(s):  
Dalowar Hossan
Keyword(s):  
Government Policy ◽  
Rural Women ◽  
Rural Areas ◽  
Women Entrepreneurs ◽  
Descriptive Statistics ◽  
Entrepreneurial Success ◽  
Factors Influencing ◽  
Proper Training ◽  
Convenience Sampling ◽  
The Government

The aim of this study is to investigate the factors influencing the entrepreneurial success of rural women entrepreneurs in Bangladesh. Non-probability sampling specifically convenience sampling is used to draw the sample and data is collected using the self-administered survey. Regression analysis and descriptive statistics are used to analyze the data. The study discloses that motivational factors, government policy and financial support have significant influence on the rural women entrepreneurial success in Bangladesh. Due to lack of suitable training and proper development as well as ICT knowledge, the rural women of Bangladesh could not accomplish the achievement. Half of the total populations of Bangladesh are female and most of them live in rural areas. Therefore, the government and the policymakers in Bangladesh should develop the potential of rural women entrepreneurs by providing development facilities, proper training, and ICT knowledge.

WOMEN AND DEVELOPMENT IN INDIA: EMPOWERMENT OF WOMEN THROUGH SKILLS DEVELOPMENT IN HAZARIBAG DISTRICT

2020 ◽  
pp. 32-33
Author(s):  
Ms. Niharika ◽  
Prof. M. K. Singh
Keyword(s):  
Rural Women ◽  
Development Policy ◽  
Vocational Training ◽  
Skill Development ◽  
Skill Training ◽  
Women Empowerment ◽  
Development Programs ◽  
Training And Education ◽  
Entrepreneurial Skills ◽  
The Government

Women are the dynamic segment and the most vibrant as well as potentially most valuable human resources. Women Empowerment has gained importance in india in the wake of economic liberalization, privatization and globalization.. The policy and institutional framework for developing entrepreneurial skills ,providing vocational training and education has widened the horizon for empowerment of women economically. In order to provide vocational training and education , skill training, entrepreneurship development to the emerging workforce, the Government of India has also introduced National Skill Development Policy and National skill Development Mission in 2009. This article explores the empowerment of women through skill development and vocational training programs. The results shows that skill development programs play a key role in empowering the rural women and the women also look positively towards income generating programs. KEYWORDS- Women Empowerment, Skill Development, Vocational Training, Government

RURAL TOURISM IN INDIA CHALLENGES AND OPPORTUNITIES

2018 ◽  
Vol 6 (26) ◽  
Author(s):  
Pankaj Sharma ◽  
Ravi Parkash
Keyword(s):  
Private Sector ◽  
Rural Areas ◽  
Economic Condition ◽  
Rural Tourism ◽  
Rural Location ◽  
Different Types ◽  
Challenges And Opportunities ◽  
Political Background ◽  
The Government

The paper analyze the role of rural tourism for the development of rural areas, The study analyzed how the different types of tourist product diversifications influence the development possibilities of studied rural areas in India. The government should sponsor private Sector to promote tourism in rural areas. For upgrading the rural tourism government requires to understand the rural location, demography, socio-culture, financial and political background of that area. How we can involve the rural citizens to improve their socio-economic condition. The objective of this paper is to present an update on rural tourism expansion and development in India. Rural tourism is rising in terms of number of visitors and the government of India should focus on it as an engine of growth

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