Inequality in utilization of cesarean delivery in Bangladesh: a decomposition analysis using nationally representative data
Date
2018
Authors
Khan, Md Nuruzzaman
Islam, Md Mofizul
Rahman, Mijanur
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Publisher
Elsevier
Abstract
Objective: This study examined the inequality in cesarean section (CS) utilization and its
socio-economic contributors.
Study design: Retrospective two-stage stratified sample design.
Methods: Data were extracted from two rounds of the Bangladesh Demographic and Health
Survey conducted in 2004 and 2014. Concentration Index of CS utilization was calculated
using the wealth quintile. Regression-based decomposition method was applied to assess
the socio-economic contributors of inequality in CS utilization.
Results: The rate of CS utilization increased from 4.98% in 2004 to 24.21% in 2014. The
utilization of CS was highly concentrated among the women of higher socio-economic
status (SES) in both rounds of the survey. Results of the decomposition models revealed
wealth quintile, higher education, higher number of antenatal visits, and being overweight
or obese as the critical factors contributing to the inequalities of CS utilization.
Conclusion: Bangladesh is now observing a rapid rise in CS utilization and women with
higher SES are the main client group of this life saving procedure. There may have inadequate access for those who are relatively less advantaged, even when CS is necessary.
Strong initiative from the government is necessary to ensure proper access to this service
regardless of women's SES.
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Keywords
Cesarean delivery, Socio-economic inequality, Decomposition analyses, Bangladesh
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Public Health
Type
Journal article
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2099-12-31
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