Association between maternal mortality and caesarean section in Ethiopia: a national cross-sectional study

Abstract Background Several studies concluded that there is a reduction of maternal deaths with improved access to caesarean section, while other studies showed the existence of a direct association between the two variables. In Ethiopia, literature about the association between maternal mortality and caesarean section is scarce. This study was aimed to assess the association between maternal mortality ratios and caesarean section rates in hospitals in Ethiopia. Methods Analysis was done of a national maternal health dataset of 293 hospitals that accessed from the Ethiopian Public Health Institute. Hospital specific characteristics, maternal mortality ratios and caesarean section rates were described. Pearson’s correlation coefficient was used to determine the direction of association between maternal mortality ratios and caesarean section rate, taking regions into consideration. Presence of a linear association between these variables was declared statistically significant at p-value < 0.05. Results The overall maternal mortality ratio in Ethiopian hospitals was 149 (95% CI: 136–162) per 100,000 livebirths. There was significant regional variation in maternal mortality ratios, ranging from 74 (95% CI: 51–104) per 100,000 livebirths in Tigray region to 548 (95% CI: 251-1,037) in Afar region. The average annual caesarean section rate in hospitals was 20.3% (95% CI: 20.2–20.5). The highest caesarean section rate of 38.5% (95% CI: 38.1–38.9) was observed in Addis Ababa, while the lowest rate of 5.7% (95% CI: 5.2–6.2) occurred in Somali region. At national level, a statistically non-significant inverse association was observed between maternal mortality ratios and caesarean section rates. Similarly, unlike in other regions, there were inverse associations between maternal mortality ratios and caesarean section rates in Addis Ababa, Afar Oromia and Somali, although associations were not statistically significant. Conclusions At national level, a statistically non-significant inverse association was observed between maternal mortality ratios and caesarean section rates in hospitals, although there were regional variations. Additional studies with a stronger design should be conducted to assess the association between population-based maternal mortality ratios and caesarean section rates.

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Association between maternal mortality and caesarean section in Ethiopia: A national cross-sectional study

10.21203/rs.3.rs-55945/v1 ◽

2020 ◽

Author(s):

Ayele Geleto Bali ◽

Catherine Chojenta ◽

Tefera Taddele ◽

Deborah Loxton

Keyword(s):

Caesarean Section ◽

Maternal Mortality ◽

Addis Ababa ◽

Caesarean Section Rate ◽

National Level ◽

Maternal Mortality Ratio ◽

P Value ◽

Inverse Association ◽

Live Births ◽

Significant Inverse Association

Abstract Background Several studies concluded that there is a reduction of maternal deaths with improved access to caesarean section, while other studies showed the existence of a direct association between the two variables. In Ethiopia, literature about the association between maternal mortality and caesarean section is scarce. This study was aimed to assess the association between maternal mortality ratios and caesarean section rates in hospitals in Ethiopia. Methods Analysis was done of a national maternal health dataset of 293 hospitals that accessed from the Ethiopian Public Health Institute. Hospital specific characteristics, maternal mortality ratios and caesarean section rates were described. Pearson’s correlation coefficient was used to determine the direction of association between maternal mortality ratios and caesarean section rate, taking regions into consideration. Presence of a linear association between these variables was declared statistically significant at p-value < 0.05. Results The overall maternal mortality ratio in Ethiopian hospitals was 149 (95% CI: 136–162) per 100,000 live births. There was significant regional variation in maternal mortality ratios, ranging from 74 (95% CI: 51–104) per 100,000 live births in Tigray region to 548 (95% CI: 251-1,037) in Afar region. The average annual caesarean section rate in hospitals was 20.3% (95% CI: 20.2–20.5). The highest caesarean section rate of 38.5% (95% CI: 38.1–38.9) was observed in Addis Ababa, while the lowest rate of 5.7% (95% CI: 5.2–6.2) occurred in Somali region. At national level, a statistically non-significant inverse association was observed between maternal mortality ratios and caesarean section rates. Similarly, unlike in other regions, there were inverse associations between maternal mortality ratios and caesarean section rates in Addis Ababa, Afar Oromia and Somali, although associations were not statistically significant. Conclusions At national level, a statistically non-significant inverse association was observed between maternal mortality ratios and caesarean section rates in hospitals, although there were regional variations. Additional studies with a stronger design should be conducted to assess the association between population-based maternal mortality ratios and caesarean section rates.

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PENGARUH MOBILISASI DINI TERHADAP PENYEMBUHAN LUKA POST OPERASI SECTIO CAESARIA DI RS SYAFIRA PEKANBARU TAHUN 2015

JURNAL PROTEKSI KESEHATAN ◽

10.36929/jpk.v4i2.35 ◽

2018 ◽

Vol 4 (2) ◽

Author(s):

WIWIEK DELVIRA ◽

FATMI AGUS

Keyword(s):

Wound Healing ◽

Maternal Mortality ◽

Maternal Mortality Ratio ◽

Early Mobilization ◽

Developed Countries ◽

Cross Sectional Study ◽

Sectio Caesarea ◽

P Value ◽

Cross Sectional ◽

Mortality Ratio

Maternal mortality used as a measure of success towards achieving the MDG's targets, namely the 75% reduction in maternal mortality ratio. In developing countries the frequency of maternal deaths reported to range between 0.3-0.7%, while in developed countries the figure is smaller, which 0.05-0.1% (Widjanarko, 2008). In accordance with the health paradigm without abandoning efforts to restore the health of patients, the need for early mobilization gradually for sectio caesarea postoperative patients while in hospital. The purpose of this study was to determine the effect of early mobilization on wound healing post sectio caesarea in RS Syafira Pekanbaru. The benefits of this research are as fulfilling the Minimum Service Standards (MSS) for the hospital that can be used as eviden based practice in the provision of nursing services independently. This study was conducted in inpatient obstetric in RS Syafira Pekanbaru on October-November 2015 with a sample of 20 respondents. The research methodology used is the cross-sectional study design. Analysis of the data used in the analysis of univariate and bivariate (t test dependent), the data were processed using a computerized program. The results obtained from this research that the influence of early mobilization with postoperative wound healing secsio Caesaria with P value (0.007).

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HUBUNGAN TINGKAT KECEMASAN DENGAN LAMA PERSALINAN KALA II PADA IBU BERSALIN DI RSIA ANUGERAH MEDICAL CENTER KOTA METRO

Midwifery Journal Jurnal Kebidanan UM Mataram ◽

10.31764/mj.v3i1.119 ◽

2018 ◽

Vol 3 (1) ◽

pp. 16

Author(s):

Yona Desni Sagita

Keyword(s):

Maternal Mortality ◽

Frequency Distribution ◽

Medical Center ◽

Maternal Mortality Ratio ◽

Anxiety Level ◽

P Value ◽

Cross Sectional ◽

Second Stage Of Labor ◽

Live Births ◽

Second Stage

Abstrak: Berdasarkan data WHO tahun 2015 Rasio kematian ibu (MMR) selama kehamilan dan melahirkan berkisar antara 102/100.000 Kelahiran Hidup. Berdasarkan SDKI Tahun 2013 bahwa Angka Kematian Ibu di Indonesia sebesar 359 per 100.000 kelahiran hidup. Provinsi Lampung memiliki 130 kasus kematian ibu pada saat hamil, melahirkan dan nifas. Studi pendahuluan di Ruang Bersalin RSIA Anugerah Medical Center Kota Metro tahun 2016 bulan November sebanyak 22 ibu dengan perpanjangan kala II. Tujuan penelitian ini untuk mengetahui hubungan tingkat kecemasan terhadap lama persalinan kala II pada ibu bersalin di RSIA Anugerah Medical Center Kota Metro Tahun 2017.Jenis penelitian kualitatif dengan desain analitik dan pendekatan cross sectional. Populasi pada penelitian ini adalah semua seluruh ibu bersalin di RSIA Anugerah Medical Center Kota Metro sebanyak 50 ibu, sedangkan sampel diambil dengan tehnik total sampling sebanyak 50 ibu. Analisis yang digunakan adalah univariat dengan distribusi frekuensi dan bivariat menggunakan uji chi square.Hasil penelitian diketahui bahwa tingkat kecemasan ibu bersalin sebagian besar dengan tingkat kecemasan sedang sebanyak 17 ibu (34%). lama persalinan kala II yang tidak normal sebanyak 22 ibu (44%). Ada hubungan antara tingkat kecemasan dengan lama persalinan kala II pada ibu bersalin dengan nilai p value: 0,009. Kesimpulan penelitian ada hubungan tingkat kecemasan terhadap lama persalinan kala II pada ibu bersalin di RSIA Anugerah Medical Center Kota Metro Tahun 2017, sehingga disarankan kepada tenaga kesehatan untuk meningkatkan berperan aktif dalam mengurangi tingkat kecemasan ibu selama proses persalinan karena berkaitan dengan gangguan pada proses persalinan. Abstract: The maternal mortality ratio (MMR) during pregnancy and childbirth ranges based on WHO data 2015 estimated from 102 / 100,000 live births. IDHS in 2013 estimated that the Maternal Mortality Rate in Indonesia amounted to 359 per 100,000 live births. Lampung province has 130 cases of maternal mortality during pregnancy, childbirth and childbirth. Preliminary study at the Maternity Room of RSIA Anugerah Medical Center Metro City in 2016 November as many as 22 mothers with second stage extension. The purpose of this study to determine the relationship of anxiety level to the second stage of labor delivery to the maternal mother at RSIA Anugerah Medical Center Metro City Year 2017.This was a quantitative research, analytic survey design with cross sectional approach. The population was whole mother of maternity in RSIA Anugerah Medical Center Metro City that consisted of 50 mother, while sample taken with total sampling technique that consisted of 50 mother. The analysis used univariate with frequency distribution and bivariate using chi square test.The result showed frequency distribution of maternal anxiety level was mostly with moderate anxiety level of 17 mothers (34%). An abnormal second stage of labor during childbirth was 22 mothers (44%). There is no relationship between the level of anxiety with the duration of labor of stage II on maternal mothers with value p value: 0.009. Conclusion of research there is correlation of anxiety level to the duration of labor of second stage at mother of maternity in RSIA Anugerah Medical Center of Metro City Year 2017. The suggestion for to health worker to increase active role in reducing mother's anxiety level during delivery process because related to disruption at delivery process.

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Patient satisfaction and associated factors among psychiatry outpatients of St Paulo’s Hospital, Ethiopia

General Psychiatry ◽

10.1136/gpsych-2019-100120 ◽

2020 ◽

Vol 33 (1) ◽

pp. e100120

Author(s):

Kebebew Wogi Goben ◽

Endalamaw Salelew Abegaz ◽

Samuel Tolesa Abdi

Keyword(s):

Patient Satisfaction ◽

Associated Factors ◽

Addis Ababa ◽

Mental Healthcare ◽

Sampling Technique ◽

Good Health ◽

Cross Sectional Study ◽

P Value ◽

Cross Sectional ◽

Male Sex

BackgroundPatient satisfaction with mental healthcare service is recognised as an important integral part of measuring the outcomes and performance of clinical service delivery. It is not well studied in Ethiopia. Therefore, it is essential to improve service in the future.AimsTo assess patient satisfaction and associated factors among psychiatry outpatients at St. Paulo’s Hospital Millennium Medical College, Addis Ababa, Ethiopia.MethodsAn institutional-based cross-sectional study was conducted with consecutive sampling technique from May to June 2018. Data were collected using a Client Satisfaction Questionnaire (CSQ-8). Both bivariate and multivariate ordinal logistic regression analyses were used. Variables with p value <0.05 at multivariate analysis were considered statistically significant.ResultsA total of 589 participants were enrolled with a response rate of 98.2%. In regard to the magnitude of patient satisfaction, 50.3% (95% CI 46.0 to 54.2) were highly satisfied, 31.0% (95% CI 27.2 to 34.8) were satisfied, and 18.7% (95% CI 15.4 to 22.1) were dissatisfied. Male sex (adjusted OR (AOR) 2.30, 95% CI 1.57 to 3.36), inability to read and write (AOR 2.23, 95% CI 1.10 to 4.66), being unemployed (AOR 1.69, 95% CI 1.15 to 2.47), obtaining services for free (AOR 1.57, 95% CI 1.11 to 2.22), and availability of medication (AOR 1.62, 95% CI 1.13 to 2.23) were significantly associated with patient satisfaction.ConclusionsThe study showed that further improvements in patient satisfaction are required. Male sex, inability to read and write, being unemployed, obtaining services free of charge, and availability of medication were significantly associated with patient satisfaction. More than half of the participants were dissatisfied with the waiting time to receive services. The provision of services within a reasonable timeframe and meeting patient expectations are helpful for good health outcomes.

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Caesarean birth rates in public and privately funded hospitals: a cross-sectional study

Revista de Saúde Pública ◽

10.11606/s1518-8787.2017051007054 ◽

2017 ◽

Vol 51 ◽

pp. 101 ◽

Cited By ~ 9

Author(s):

Bruna Dias Alonso ◽

Flora Maria Barbosa da Silva ◽

Maria do Rosário Dias de Oliveira Latorre ◽

Carmen Simone Grilo Diniz ◽

Debra Bick

Keyword(s):

Health Care ◽

Socioeconomic Status ◽

Caesarean Section ◽

Caesarean Section Rate ◽

Cross Sectional Study ◽

University Education ◽

Southeastern Brazil ◽

Sectional Study ◽

Cross Sectional ◽

Health Care Funding

OBJECTIVE: To examine maternal and obstetric factors influencing births by cesarean section according to health care funding. METHODS: A cross-sectional study with data from Southeastern Brazil. Caesarean section births from February 2011 to July 2012 were included. Data were obtained from interviews with women whose care was publicly or privately funded, and from their obstetric and neonatal records. Univariate and multivariate analyses were conducted to generate crude and adjusted odds ratios (OR) with 95% confidence intervals (95%CI) for caesarean section births. RESULTS: The overall caesarean section rate was 53% among 9,828 women for whom data were available, with the highest rates among women whose maternity care was privately funded. Reasons for performing a c-section were infrequently documented in women’s maternity records. The variables that increased the likelihood of c-section regardless of health care funding were the following: paid employment, previous c-section, primiparity, antenatal and labor complications. Older maternal age, university education, and higher socioeconomic status were only associated with c-section in the public system. CONCLUSIONS: Higher maternal socioeconomic status was associated with greater likelihood of a caesarean section birth in publicly funded settings, but not in the private sector, where funding source alone determined the mode of birth rather than maternal or obstetric characteristics. Maternal socioeconomic status and private healthcare funding continue to drive high rates of caesarean section births in Brazil, with women who have a higher socioeconomic status more likely to have a caesarean section birth in all birth settings.

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Factors associated with maternal near-miss at public hospitals of South-East Ethiopia: An institutional-based cross-sectional study

Women s Health ◽

10.1177/17455065211060617 ◽

2021 ◽

Vol 17 ◽

pp. 174550652110606

Author(s):

Ashenafi Mekonnen ◽

Genet Fikadu ◽

Kenbon Seyoum ◽

Gemechu Ganfure ◽

Sisay Degno ◽

...

Keyword(s):

Maternal Mortality ◽

Rural Areas ◽

Cross Sectional Study ◽

Public Hospitals ◽

Near Miss ◽

Early Marriage ◽

Maternal Near Miss ◽

P Value ◽

Sectional Study ◽

Cross Sectional

Introduction: Maternal near-miss precedes maternal mortality, and women are still alive indicating that the numbers of near-misses occur more often than maternal mortality. This study aims to assess the prevalence of maternal near-miss and associated factors at public hospitals of Bale zone, Southeast Ethiopia. Methods: Facility-based cross-sectional study design was carried out from 1 October 2018 to 28 February 2019, among 300 women admitted to maternity wards. A structured questionnaire and checklist were used to collect data. Epi-info for data entry and statistical package for social science for analysis were used. The descriptive findings were summarized using tables and text. Adjusted odds ratio with 95% confidence interval and p-value < 0.05 were used to examine the association between the independent and dependent variables. Result: The prevalence of maternal near-miss in our study area was 28.7%. Age < 20 years, age at first marriage < 20 years, husbands with primary education, and being from rural areas are factors significantly associated with the prevalence of maternal near-miss. The zonal health department in collaboration with the education department and justice office has to mitigate early marriage by educating the community about the impacts of early marriage on health.

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Hubungan Pemberian Anestesi Regional Dengan Kelancaran ASI Pada Ibu Post Partum Sectio Caesarea Di Rumah Sakit Muhammadiyah Gresik

MAGNA MEDICA: Berkala Ilmiah Kedokteran dan Kesehatan ◽

10.26714/magnamed.7.2.2020.42-48 ◽

2020 ◽

Vol 7 (2) ◽

pp. 42

Author(s):

Vina Rahmatika ◽

Musa Ghufron ◽

Nenny Triastuti ◽

Syaiful Rochman

Keyword(s):

Breast Milk ◽

Caesarean Section ◽

Post Partum ◽

Secondary Data ◽

Sampling Technique ◽

Primary Data ◽

Sectio Caesarea ◽

P Value ◽

Cross Sectional ◽

Anesthetic Drugs

Background: The birth rate by caesarean section method is getting higher. Risk data for 2013 shows the method of birth with the operation method of 9.8 percent of the total 49,603 births during 2010 to 2013. Being in practice the mother must be given anesthetic before the surgery begins. This anesthesia will later affect the pain that will occur after SC. Purpose: The purpose of this study was to determine the correlation between regional anesthetic drugs and the smoothness of breast milk in women born in sectio caesarea at Muhammadiyah Gresik Hospital. Method: Method with Cross Sectional approach. The population in this study mothers who gave birth in a caesarean section at Muhammadiyah Hospital Gresik in December 2019 to January 2020. The sampling technique in this study is probability / random simple sampling. The sample in this study was a portion of mothers who gave birth in a caesarean section at Muhammadiyah Gresik Hospital. The instrument used was primary data collection in the form of questionnaires and secondary data in the form of patient medical records. Result: The data obtained in this study were processed using spearman correlation statistics. From the statistical test the Correlation coefficient value was 0.807, and obtained P-Value equal to 0,000 this value is less than 0.05. Conclusion: The conclusion of this study is that there is a correlation between the administration of a regional anesthetics and the smoothness of breast milk in mothers of post partum caesarea at Muhammadiyah Gresik Hospital.

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Magnitude and associated factors of Perioperative hypothermia in patients who underwent Elective surgery at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia.

International Journal Of Medical Science And Clinical Invention ◽

10.18535/ijmsci/v6i2.10 ◽

2019 ◽

Vol 6 (2) ◽

pp. 4332-4336 ◽

Cited By ~ 1

Author(s):

Mulualem S. Fekede ◽

Wosenyeleh A. Sahile

Keyword(s):

Body Temperature ◽

Room Temperature ◽

Elective Surgery ◽

Addis Ababa ◽

Core Body Temperature ◽

P Value ◽

Healthy Human ◽

Cross Sectional ◽

Perioperative Hypothermia ◽

Core Body

Background : Body temperature is a vital sign and 37°C is the mean core body temperature of a healthy human. Core body temperature is normally tightly regulated and maintained within narrow range. Perioperative hypothermia is one of the major problems during surgery and anesthesia that can affect operated patients. Methods: Institutional based cross-sectional study was conducted. Patient interview, chart review and temperature measurement were employed for data collection. Temperature was measured using tympanic membrane thermometer. SPSS version 20 software was used for analysis. binary logistic regression was used to look at associations anda p-value of <0.05 was considered statistically significant. Result :The overall magnitude of preoperative, intra and post-operative hypothermia in this study was 16.2%, 53.2% and 31.3%, respectively. Age (AOR=7.15, 95% CI, 1.16, 43.99), coexisting illness (AOR, 3.32, 95% CI, 1.06; 10.36), preoperative hypothermia (AOR; 57; 95% CI; 7.1, 455.4), operation room temperature (AOR=1.91; 95 % CI, 1.04; 3.5) and crystalloid fluids administered (AOR; 2.3; 95% CI, 1.07, 4.9) were found to be factors associated with intraoperative hypothermia. Conclusion and recommendation: The magnitude of perioperative hypothermia remains high. Measures should focus on improving room temperature and warming up fluids. Susceptible patients like the aged and those with coexisting disease should be given extra attention.

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Caesarean section at Koudougou regional hospital centre: indications and prognosis

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20205211 ◽

2020 ◽

Vol 9 (12) ◽

pp. 4792

Author(s):

Djiguemde Nebnomyidboumbou Norbert Wenceslas ◽

Lankaonde Martin ◽

Savadogo-Komboigo B. Eveline ◽

S. I. B. Sansan Rodrigue ◽

Ouedraogo Wendlassida Estelle ◽

...

Keyword(s):

Caesarean Section ◽

Cesarean Section ◽

Caesarean Section Rate ◽

Cross Sectional Study ◽

Cross Sectional ◽

Important Place ◽

History Of ◽

Group 3 ◽

Group 5 ◽

Uterine Scar

Background: Objective was to study the indications and the prognosis of cesarean section in the obstetrics and gynecology department of CHR Koudougou from August 1st to October 16th 2018.Methods: This was a cross-sectional study for descriptive purposes with prospective collection of data over the month and monitoring of parturients up to the 42nd day post caesarean section. The study covered the period from August 1 to October 16, 2018. Gestures received in the work room and those hospitalized for a scheduled cesarean were involved in this study.Results: This study involved 316 deliveries. The caesarean section rate was 34.8% (n=110). The average age was 26.75 years with extremes of 12 and 42 years. Term pregnancies represented 90.9%. History of cesarean section was observed in 47, 3%. The main groups contributing to the caesarean section rate represent: Groups 5 (9.5%), Group 1 (9.2%), Group 3 (5.1%), the scar uterus (17.3%) and suffering fetal (14.6%). The reported complications were 15.5% including 3.6% parietal suppuration and 0.8% stillbirth.Conclusions: The caesarean section occupies an important place in the maternity service of the RHC of Koudougou. Robson's group 5 was the largest contributor to the overall cesarean rate in our study. Measures should be taken in this group so that the uterine scar does not become an absolute indication for cesarean.

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Prevalence and Associated Factors of Depression among Orphan Adolescents in Addis Ababa, Ethiopia

Psychiatry Journal ◽

10.1155/2018/5025143 ◽

2018 ◽

Vol 2018 ◽

pp. 1-6 ◽

Cited By ~ 2

Author(s):

Mekdes Beze Demoze ◽

Dessie Abebaw Angaw ◽

Haregwoin Mulat

Keyword(s):

Social Support ◽

Length Of Stay ◽

Associated Factors ◽

Adolescent Depression ◽

Perceived Social Support ◽

Addis Ababa ◽

Depression Scale ◽

P Value ◽

Cross Sectional ◽

Prevalence Of Depression

Background. Orphan adolescents are a special group of people who are generally deprived and prone to develop psychiatric disorder even if reared in a well-run institution. Objective. To assess the prevalence and associated factors of depression among orphan adolescents living in Addis Ababa orphan centers, Addis Ababa, Ethiopia. Method. A cross-sectional study was conducted in 2016 among 453 orphan adolescents in Ethiopia. All orphan adolescents who were living in the selected orphan centers were included in the study. The data was collected by interviewing the orphan adolescents at the orphan center by using a structured questionnaire. Kocher adolescent depression scale and MSPSS scale were used to measure orphan level of depression and their perceived social support. After appropriate coding, the collected data had been entered into EPI info version 7 and it was exported to SPSS version 20 for further analysis. The OR with 95% CI was used to measure association and p value < 0.05 was used as statistically significant value in multivariable binary logistic regressions. Result. The overall prevalence of depression among the orphan adolescents was found to be 36.4%. The majority of the respondents, 302 (66.7%), were within the age range of 15-19 years. Perceived social support (OR 5.86; 95% CI 3.47, 9.91), community discrimination (OR 2.68; 95% CI 1.58, 4.56), length of stay (OR 1.90; 95% CI 1.08, 3.35), age of entrance (OR 2.21; 95% CI 1.32, 3.69), and presence of visitors (OR 3.62; 95% CI 2.06, 6.37) were the main variables associated with depression. Conclusion. The prevalence of depression among orphan adolescents was found to be high. Low level of social support, higher length of stay, community discrimination, the presence of visitors, and younger age of entrance were statistically significant variables to develop depression.

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