ArticlePaediatric and perinatal epidemiology2022
Geographic variation in caesarean delivery in India.
Article in Paediatric and perinatal epidemiology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 4 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
4 citing papers in PubMed, 7 citations in OpenAlex.
- Region-specific variation and determinants of caesarean delivery among ever-married women in Bangladesh.PloS one · 2025Article
- Multilevel analysis of determinants in postnatal care utilisation among mother-newborn pairs in India, 2019-21.Journal of global health · 2024Article
- Cesarean sections and social inequalities in 305 cities of Latin America.SSM - population health · 2022Article
- Geographic variation in caesarean delivery in India.Paediatric and perinatal epidemiology · 2022Article
Corrections and comments
- Erratum issuedErratum.2022
Authors and funding
5 authors at 4 institutions in 5 countries.
Funding
Abstract
backgroundThe rate of caesarean delivery has increased markedly both globally and within India. However, there is considerable variation within countries. No previous studies have examined the relative importance of multiple geographic levels in shaping the distribution of caesarean delivery and to what extent they can be explained by individual-level risk factors.
objectivesTo describe geographic variation in caesarean delivery and quantify the contribution of individual-level risk factors to the variation in India.
methodsWe conducted four-level logistic regression analysis to partition total variation in caesarean delivery to three geographic levels (states, districts and communities) and quantify the extent to which variance at each level was explained by a set of 20 sociodemographic, medical and institutional risk factors. Stratified analyses were conducted by the type of delivery facility (public/private).
resultsOverall prevalence of caesarean delivery was 19.3% in India in 2016. Most geographic variation was attributable to states (44%), followed by communities (32%), and lastly districts (24%). Adjustment for all risk factors explained 44%, 52% and 46% of variance for states, districts and communities, respectively. The proportion explained by individual risk factors was larger in public facilities than in private facilities at all three levels. A substantial proportion of between-population variation still existed even after clustering of individual risk factors was comprehensively adjusted for.
conclusionsDiverse contextual factors driving high or low rate of caesarean delivery at each geographic level should be explored in future studies so that tailored intervention can be implemented to reduce the overall variation in caesarean delivery.
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