Prevalence and Factors Associated with Cesarean Section at UTH Women and Newborn Hospital Lusaka, Zambia

Abstract

Background: Increase in cesarean section (CS) has been a source of public health concern globally. There is scanty updated information about cesarean section and associated factors in developing countries like Zambia. The aim of this study was to determine the prevalence of CS and associated factors at The University Teaching Hospital women and New-born in Lusaka Zambia. Methodology: The study design was cross sectional. It involved retrospective collection of data from birth registers of women who gave birth at the University Teaching Hospital-Women and Newborn from 1st January, 2018 to 31st December 2018. The total sample size was 6,965 women (15-49 years) after the inclusion and exclusion criteria were met. Statistical analysis was conducted using Binary Logistic Regression, level of significance was 0.05 and Confidence Interval of 95%. Goodness of fit was conducted using the likelihood ratio test. Data was analyzed using STATA version 14.2. Results: The Prevalence of Cesarean section was 44%. Factors significantly associated with Cesarean Section were maternal age (grouped), Birth weight (grouped), gestational age (grouped) and still birth (AOR=0.47 P<0.0001). There was an increased odds of having Cesarean Section among multipara (AOR= 1.10 P=0.73) and Multigravida (AOR=1.04, P=0.73). Common maternal indicators identified were repeat caesarean section (18%), obstructed labor (11%) and failure to progress (10%). The common fetal indicators identified were fetal distress (18%), big baby (10%) and mal presentation (7%). Conclusion: Prevalence is higher than the recommended WHO limit. There is need to reinforce health education, reinforce fetal monitoring and promote vaginal birth after caesarean. Keywords: Cesarean Section, Prevalence, Factors, Women and newborn, Zambia.