Rural-urban disparities and socioeconomic determinants of caesarean delivery rates in Zimbabwe: Evidence from the 2019 National Multiple Indicator Cluster Survey
Caesarean sections (CSs) have increased globally, with concerns being raised involving overutilisation and inequalities in access. In Zimbabwe, where healthcare access varies greatly, we aimed to analyse factors associated with ever having a CS using the 2019 National Multiple Indicator Cluster...
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| Language: | English |
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South African Medical Association
2024-07-01
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| Series: | South African Medical Journal |
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| Online Access: | https://samajournals.co.za/index.php/samj/article/view/1882 |
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| author | G N Musuka G Murewanhema H Herrera E Mbunge R Birri-Makota T Dzinamarira D Cuadros I Chingombe A Mpofu M Mapingure |
| author_facet | G N Musuka G Murewanhema H Herrera E Mbunge R Birri-Makota T Dzinamarira D Cuadros I Chingombe A Mpofu M Mapingure |
| author_sort | G N Musuka |
| collection | DOAJ |
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Caesarean sections (CSs) have increased globally, with concerns being raised involving overutilisation and inequalities in access. In Zimbabwe, where healthcare access varies greatly, we aimed to analyse factors associated with ever having a CS using the 2019 National Multiple Indicator Cluster Survey. The weighted national CS rate was 10.3%, and CS happened more commonly among women in urban than rural areas (15.7% v. 7.4%; odds ratio (OR) 2.34; (95% confidence interval (CI)) 1.71 - 3.20; p=0.001). Percentages of those having a CS significantly increased with education: overall χ2 for a trend of p=0.001 and wealth quintile, and overall χ2 for a trend of p=0.001. Women with insurance coverage were more likely to have had a CS than those without: 26.7% v. 8.7%; OR 3.82; 95% CI 2.51 - 5.83; p=0.001. The same was the case for women with access to the internet: 15.4% v. 7.0%, OR 2.42; 95%CI 1.71 - 3.41; p=0.001). These findings show an association that could indicate this being overutilised by insured women in urban settings, rather than being accessible based on clinical needs. Further research should explore reasons for these disparities and inform interventions to ensure equitable access to optimum childbirth in Zimbabwe.
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| format | Article |
| id | doaj-art-65fbbbd3c76846008538911179bc68ba |
| institution | Kabale University |
| issn | 0256-9574 2078-5135 |
| language | English |
| publishDate | 2024-07-01 |
| publisher | South African Medical Association |
| record_format | Article |
| series | South African Medical Journal |
| spelling | doaj-art-65fbbbd3c76846008538911179bc68ba2025-02-10T12:25:50ZengSouth African Medical AssociationSouth African Medical Journal0256-95742078-51352024-07-01114710.7196/SAMJ.2024.v114i17.1882Rural-urban disparities and socioeconomic determinants of caesarean delivery rates in Zimbabwe: Evidence from the 2019 National Multiple Indicator Cluster SurveyG N Musuka0G Murewanhema1H Herrera2E Mbunge3R Birri-Makota4T Dzinamarira5D Cuadros6I Chingombe7A Mpofu8M Mapingure9Innovative Public Health and Development Solutions, Harare, ZimbabweUnit of Obstetrics and Gynaecology, Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare, ZimbabweSchool of Pharmacy and Biomedical Science, University of Portsmouth, UKDepartment of Computer Science, Faculty of Science and Engineering, University of Eswatini, Kwaluseni, EswatiniDepartment of Biological Sciences and Ecology, Faculty of Science, University of Zimbabwe, Harare, ZimbabweSchool of Health Systems and Public Health, University of Pretoria, South Africa Digital Epidemiology Laboratory, University of Cincinnati, USAInnovative Public Health and Development Solutions, Harare, Zimbabwe National AIDS Council, Harare, ZimbabweInnovative Public Health and Development Solutions, Harare, Zimbabwe Caesarean sections (CSs) have increased globally, with concerns being raised involving overutilisation and inequalities in access. In Zimbabwe, where healthcare access varies greatly, we aimed to analyse factors associated with ever having a CS using the 2019 National Multiple Indicator Cluster Survey. The weighted national CS rate was 10.3%, and CS happened more commonly among women in urban than rural areas (15.7% v. 7.4%; odds ratio (OR) 2.34; (95% confidence interval (CI)) 1.71 - 3.20; p=0.001). Percentages of those having a CS significantly increased with education: overall χ2 for a trend of p=0.001 and wealth quintile, and overall χ2 for a trend of p=0.001. Women with insurance coverage were more likely to have had a CS than those without: 26.7% v. 8.7%; OR 3.82; 95% CI 2.51 - 5.83; p=0.001. The same was the case for women with access to the internet: 15.4% v. 7.0%, OR 2.42; 95%CI 1.71 - 3.41; p=0.001). These findings show an association that could indicate this being overutilised by insured women in urban settings, rather than being accessible based on clinical needs. Further research should explore reasons for these disparities and inform interventions to ensure equitable access to optimum childbirth in Zimbabwe. https://samajournals.co.za/index.php/samj/article/view/1882Caesarean Section, Women, MICS 2019 , Zimbabwe |
| spellingShingle | G N Musuka G Murewanhema H Herrera E Mbunge R Birri-Makota T Dzinamarira D Cuadros I Chingombe A Mpofu M Mapingure Rural-urban disparities and socioeconomic determinants of caesarean delivery rates in Zimbabwe: Evidence from the 2019 National Multiple Indicator Cluster Survey South African Medical Journal Caesarean Section, Women, MICS 2019 , Zimbabwe |
| title | Rural-urban disparities and socioeconomic determinants of caesarean delivery rates in Zimbabwe: Evidence from the 2019 National Multiple Indicator Cluster Survey |
| title_full | Rural-urban disparities and socioeconomic determinants of caesarean delivery rates in Zimbabwe: Evidence from the 2019 National Multiple Indicator Cluster Survey |
| title_fullStr | Rural-urban disparities and socioeconomic determinants of caesarean delivery rates in Zimbabwe: Evidence from the 2019 National Multiple Indicator Cluster Survey |
| title_full_unstemmed | Rural-urban disparities and socioeconomic determinants of caesarean delivery rates in Zimbabwe: Evidence from the 2019 National Multiple Indicator Cluster Survey |
| title_short | Rural-urban disparities and socioeconomic determinants of caesarean delivery rates in Zimbabwe: Evidence from the 2019 National Multiple Indicator Cluster Survey |
| title_sort | rural urban disparities and socioeconomic determinants of caesarean delivery rates in zimbabwe evidence from the 2019 national multiple indicator cluster survey |
| topic | Caesarean Section, Women, MICS 2019 , Zimbabwe |
| url | https://samajournals.co.za/index.php/samj/article/view/1882 |
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