ArticleInternational health2021
Inequalities in access to birth by caesarean section in the context of user fee exemption for maternal health services in southwest and north central Nigeria.
Article in International health, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed.
- Attitude and subjective norms as predictors of intention of married men and women to accept caesarean section delivery in Lagos, Nigeria.Reproductive health · 2026Article
- A Systematic Review of Government-Led Free Caesarean Section Policies in Low- and Middle-Income Countries from 2009 to 2025.Healthcare (Basel, Switzerland) · 2025Review
- Caesarean section and associated factors in Nigeria: assessing inequalities between rural and urban areas-insights from the Nigeria Demographic and Health Survey 2018.BMC pregnancy and childbirth · 2024Article
- Strengthening caesarean birth: Sub-Saharan Africa health system evaluation: Scoping review.African journal of primary health care & family medicine · 2024Article
- Financing for equity for women's, children's and adolescents' health in low- and middle-income countries: A scoping review.PLOS global public health · 2024Article
- Rural-urban disparities in caesarean deliveries in sub-Saharan Africa: a multivariate non-linear decomposition modelling of Demographic and Health Survey data.BMC pregnancy and childbirth · 2022Article
- The true costs of cesarean delivery for patients in rural Rwanda: Accounting for post-discharge expenses in estimated health expenditures.International journal for equity in health · 2022Article
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1 author.
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Abstract
backgroundUser fee exemption for maternal healthcare services was introduced with a focus on providing free maternal health services, including caesarean sections (CS), in Nigeria. This policy has had a positive impact on access to facility-based delivery; however, the extent to which inequality in access to CS exists in the context of user fee exemption is unclear. The objective of this study was to examine inequalities in access to birth by CS 5 y after the implementation of the user fee exemption policy.
methodsData were obtained from 1227 women who gave birth between 2011 and 2015 and were selected using cluster random sampling between May and August 2016 from two of the six main regions of the country. Adjusted and unadjusted binary logistic regression models were performed.
resultsAn overall CS rate of 6.1% was found, but varied by income, education and place of residence. Women who earned a monthly income of ≤20 000 naira (US${\$}$150) were 50% less likely to have a birth by CS compared with those who earned more. Compared with women who were educated to the tertiary level, women who had a secondary education or less were 51% less likely to give birth by CS.
conclusionsThis study shows that inequality in access to CS persists despite the implementation of free maternal healthcare services.
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