ArticleBMC public health2018
High prevalence of cesarean section births in private sector health facilities- analysis of district level household survey-4 (DLHS-4) of India.
Article in BMC public health, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 49 papers.
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49 citing papers in PubMed, 124 citations in OpenAlex.
- Rising C-section use and the private maternal health care sector in Pakistan: evidence from the 2012-13 and 2017-18 Demographic and Health Surveys.BMC pregnancy and childbirth · 2025Article
- Health system drivers of caesarean deliveries in south Asia: a scoping review.The Lancet regional health. Southeast Asia · 2025Review
- Trends in nulliparous singleton alive births by cesarean section in India: Empirical patterns across public and private hospitals for 720 districts, 2016-2021.PLOS global public health · 2025Article
- Prevalence and determinants of adverse pregnancy outcomes among teenage mothers in the Limbe Health District of Cameroon.The Pan African medical journal · 2025Article
- Preventing the preventable: Assessing the burden of incessant caesarean deliveries in select Indian states using NFHS-5.PloS one · 2025Article
- Impact of normal vs. caesarean deliveries on child nutritional status and mortality in India: insights from NFHS-5 data.BMC pediatrics · 2024Article
- Determinants of cesarean mode of childbirth among Rwandan women of childbearing age: Evidence from the 2019-2020 Rwanda Demographic and Health Survey (RDHS).Public health challenges · 2024Article
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- A Higher Maternal Education Level Could Be a Critical Factor in the Exceeded Cesarean Section Delivery in Indonesia.Iranian journal of public health · 2024Article
- What to scale first? A cross-sectional analysis of factors affecting cesarean delivery rates at first referral units in Bihar, India.Global health action · 2023Article
- Low-Value Surgical Procedures in Low- and Middle-Income Countries: A Systematic Scoping Review.JAMA network open · 2023Article
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- Evaluating the status of the Lancet Commission on Global Surgery indicators for India.The Lancet regional health. Southeast Asia · 2023Review
- Individual and community-level factors associated with caesarean section in Haiti: secondary analysis of data from the 2016-2017 Haitian Demographic and Health Survey.Tropical medicine and health · 2023Article
- Alarming Trends of Cesarean Section-Time to Rethink: Evidence From a Large-Scale Cross-sectional Sample Survey in India.Journal of medical Internet research · 2023Article
- Leadership Driven Persistent Reduction in Cesarean Trends: An Interventional Study for Quality Improvement.Journal of obstetrics and gynaecology of India · 2023Article
- Multilevel analysis to identify the factors associated with caesarean section in Bangladesh: evidence from a nationally representative survey.International health · 2023Article
- Determinants of a high prevalence of cesarean section among women in eastern Uganda.The Pan African medical journal · 2023Article
- Article
- Does Obesity Influence Women's Decision Making about the Mode of Delivery?Journal of clinical medicine · 2022Article
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Authors and funding
3 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundWorldwide rising cesarean section (CS) births is an issue of concern. In India, with increase in institutional deliveries there has also been an increase in cesarean section births. Aim of the study is to quantify the prevalence of cesarean section births in public and private health facility, and also to determine the factors associated with cesarean section births.
methodsWe analyzed data from district level household survey data 4 (DLHS-4) combined individual level dataset for 19 states/UTs of India comprising 24,398 deliveries resulting in 22,111 live births for year 2011. The percentages and Chi-square has been computed for the select variables viz. Socio demographic, maternal, antenatal care and delivery related based on type of births (CS Vs normal births). The multiple logistic regression model has been used to identify the potential risk factors associated with CS births.
resultsOf 22,111 live birth analyzed 49.2% were delivered at public sector, 31.9% at private sector and 18.9% were home deliveries. Prevalence of CS births were 13.7% (95% CI; 13.0- 14.3%) and 37.9% (95% CI; 36.7- 39.0%) in the public and private sectors, respectively. Higher odds of CS births were observed with- delivery at private health facility (OR 3.79; 95% C.I 3.06-4.72), urban residence (OR 1.15; 95% C.I 1.00- 1.35), first delivery after 35 years of maternal age (OR 5.5; 95% C.I 1.85- 16.4), hypertension in pregnancy (OR 1.32; 95% C.I 1.06- 1.65) and breach presentation (OR 2.37; 95% C.I. 1.63- 3.43).
conclusionsOur findings shows that CS births are nearly three times more in private as compared to public sector health facilities.The higher rates of CS births, especially in private sector, not only increase the cost of care but may pose unnecessary risks to women (when there is no indications for CS). The government of India need to take measures to strengthen existing public health facilities as well as ensure that cesarean sections are performed based upon medical indications in both public and private sector health facilities.
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