Abstract
Background
Cesarean section delivery prevalence rate has been in an alarming increase worldwide each year; there are large disparities of CS proportion among women who give birth at a public and private health facility. However, there is a lack of evidence regarding the underlying factors and the proportion of CS delivery in public and private health facilities. Therefore this study aimed to asses and compare the prevalence of CS delivery and associated factors among public and private health facilities delivered mother in Bahir Dar city, Amhara region, Ethiopia,
Methods
An institution-based comparative cross-sectional study design was conducted from March1-April 15, 2019 health facility in Bahir Dar city. Study participants 724(362 for each public and private facility) were recruited through a systematic random sampling technique. Structured interview administered questionnaires and chart review checklist were used to collect data. The data were entered with Epi info version 7.2 and analyzed using SPSS version 23.0 software. A binary logistic regression model was fitted and an adjusted odds ration with 95% CI was used to determine the presence and strength of association between independent variables and cesarean section delivery.
Results
The response rate was 98.3% and 97.2% for public and private health facilities respectively. The prevalence of CS in private health facilities was198 (56.3%) (95%CI: 50.9, 61.4) and 98 (27.5%) (95%CI: 22.8, 32.2) was in public health facilities. Overall prevalence of CS delivery was 296(41.8%) (95% CI: 38.4, 45.5). Breech presentation (AOR=3.64; 95%CI (1.49, 8.89), urban residence (AOR=6.54; 95%CI (2.59, 16.48) and being referred (AOR=2.44; 95%CI (1.46, 4.08)were variables significantly associated with CS among public facility whereas age between 15-24 (AOR=0.20, 95% CI; 0.07,0.52),governmental employee (AOR=2.28;95%CI (1.39,3.75),self-employed (AOR=3.73;95%CI(1.62,8.59),Para one(AOR=6.79;95%CI(2.02,22.79) Para two (AOR=3.88;95% CI(1.15,13.08), and wealth index being highest level of wealth asset AOR=5.39; 95%CI (1.08, 26.8) in private health facility:
Conclusion and recommendation
We concluded that there is a statistically significant difference in the prevalence of CS delivery in public and private health facilities. Therefore, there should be a mechanism for a medical audit of labor management.