A multilevel analysis of the predictors of access to Caesarean Section services among women who deliver from institutionalized facilities in Uganda

Henry Nsobya, Uganda Development and Health Associates
Elizabeth Nansubuga, Makerere Unviersity

The prevalence of caesarean sections (CS) in the sub-Saharan Africa has increased – doubling in 2000/1 – 2016 in Uganda. This study examines the factors that are associated with uptake of caesarean section services and highlights areas that require priority attention to achieve targets on Sustainable Development Goals. The Uganda Demographic Health Survey (2016) was analyzed using a multilevel mixed effects logistic regression. The dependent variable was recent birth delivered by caesarean section. Women who had recent institutionalized place of delivery were included. A weighted sample size of 7786 was analyzed. The odds of having a CS were higher for richest wealth status, the Bunyoro and Tooro sub region, attending 5 and more antenatal visits and health insurance cover. The odds were lower for the Busoga, Bugishu and Bukedi sub regions and 2+ parity. There were significant variations among women characteristics attending government hospitals, government health facilities and private health facilities. Priority should focus on motivating women to attend 5+ ANC visits, especially those with 2+ parity and; Removing institutional structure, EMNOC functionality barriers and creation of a positive perception of the communities towards government hospitals and health facilities. Future research should explore in-depth non-medical indications for CS deliveries.

Keywords: Sexual and Reproductive Health and Rights, Fertility and childbirth, Multi-level modeling

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  Presented in Session 95. Maternal Health Care and Associated Needs