ArticlePloS one2020
Does delivery in private hospitals contribute largely to Caesarean Section births? A path analysis using generalised structural equation modelling.
Article in PloS one, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
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13 citing papers in PubMed, 1 synthesis or guideline pooled it, 28 citations in OpenAlex.
- Caesarean section in pregnancies conceived by assisted reproductive technology: a systematic review and meta-analysis.BMC pregnancy and childbirth · 2021Pooled it
- Article
- 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
- Prevalence and associated factors of caesarean section delivery: analysis from the Nepal Demographic and Health Survey 2022.BMJ open · 2025Article
- Patients preference for mode of delivery in a Middle Eastern society: a cross-sectional study.Frontiers in medicine · 2025Article
- Socioeconomic disadvantage and long-term survival duration in out-of-hospital cardiac arrest patients: A population-based cohort study.Resuscitation plus · 2024Article
- Comparing the outcomes of termination of second trimester pregnancy with a live fetus using intravaginal misoprostol between women with and without previous cesarean section.BMC pregnancy and childbirth · 2024Article
- Evolution of cesarean sections in Colombia and its association with the legal standing of the institutions where deliveries take placeRevista colombiana de obstetricia y ginecologia · 2023Article
- Use of path analysis to predict changes to community pharmacy and GP emergency hormonal contraception (EHC) provision in England.BMJ open · 2022Article
- Effect of checklist based box system interventions on improving institutional delivery among reproductive age women in Northwest Ethiopia: generalized structural equation modeling.Archives of public health = Archives belges de sante publique · 2022Article
- What matters most for early childhood development? Evidence from Malda district, India.PloS one · 2022Article
- Too many yet too few caesarean section deliveries in Bangladesh: Evidence from Bangladesh Demographic and Health Surveys data.PLOS global public health · 2022Article
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Authors and funding
1 author at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe rate of Caesarean Section (CS) deliveries has shown an alarming rise in recent years. CS is a surgical procedure used when there is apprehension of risk to the life of mother or baby in case of vaginal delivery, but its rates higher than 10-15 per cent are not justifiable. It is well recognised that a CS delivery could have a large number of adverse impacts on women and infants. Several studies, especially in developing countries, have revealed that delivery in private hospitals is one of the most contributing factors in CS deliveries. The present study conceptualises a causal pathway in which the possible risk factors, socio-economic, maternal and pregnancy-related, as well as institutional, influence the chances of CS delivery. It is hypothesised that certain factors would contribute to CS deliveries largely indirectly through the place of delivery, that is, either a public or private institution. METHODS AND
findingsTo test the hypotheses, this study analysed 146,280 most recent live births delivered in hospitals during the five years preceding the fourth round of India's National Family Health Survey (NFHS-4), carried out during 2015-2016. The analysis, using generalised structural equation modelling (GSEM), revealed that many exogenous variables considered in the path models influence CS deliveries significantly, directly and/or indirectly through the place of delivery factor. Prominent among these are wealth index and receiving ANC services at only private hospitals; the total effects of these variables are even higher than the direct/total effect of place of delivery.
conclusionFrom this finding, it could be said that the place of delivery is a proximate determinant of a CS delivery or a mediator of other co-factors. Interventions to curb higher CS deliveries should be focused on improving the quality of public health sectors and on developing protocols for CS deliveries.
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