ArticleBMC pregnancy and childbirth2023
A log-binomial Bayesian geoadditive semiparametric analysis of geographical inequalities in caesarean births in Ghana.
Article in BMC pregnancy and childbirth, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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2 citing papers in PubMed.
- Prevalence and Determinants of Caesarean Section Deliveries in Ghana: A Population-Based Cross-sectional Study.Public health in practice (Oxford, England) · 2025Article
- Caesarean section delivery and its associated factors in Ghana: A multilevel analysis.PloS one · 2025Article
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Abstract
backgroundCaesarean section is a clinical intervention aimed to save the lives of women and their newborns. In Ghana, studies have reported inequalities in use among women of different socioeconomic backgrounds. However, geographical differentials at the district level where health interventions are implemented, have not been systematically studied. This study examined geographical inequalities in caesarean births at the district level in Ghana. The study investigated how pregnancy complications and birth risks, access to health care and affluence correlate with geographical inequalities in caesarean section uptake.
methodsThe data for the analysis was derived from the 2017 Ghana Maternal Health Survey. The log-binomial Bayesian Geoadditive Semiparametric regression technique was used to examine the extent of geographical clustering in caesarean births at the district level and their spatial correlates.
resultsIn Ghana, 16.0% (95% CI = 15.3, 16.8) of births were via caesarean section. Geospatial analysis revealed a strong spatial dependence in caesarean births, with a clear north-south divide. Low frequencies of caesarean births were observed among districts in the northern part of the country, while those in the south had high frequencies. The predominant factor associated with the spatial differentials was affluence rather than pregnancy complications and birth risk and access to care.
conclusionsStrong geographical inequalities in caesarean births exist in Ghana. Targeted and locally relevant interventions including health education and policy support are required at the district level to address the overuse and underuse of caesarean sections, to correspond to the World Health Organisation recommended optimal threshold of 10% to 15%.
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