Caesarean section and associated factors in Nigeria: assessing inequalities between rural and urban areas—insights from the Nigeria Demographic and Health Survey 2018
Introduction: When medically indicated, caesarean section (CS) can be a life-saving intervention for mothers and their newborns. This study assesses the prevalence of CS and its associated factors, focussing on inequalities between rural and urban areas in Nigeria. Methods: We disaggregated the Nige...
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Journal Article |
| Language: | English |
| Published: |
2024
|
| Subjects: | |
| Online Access: | http://hdl.handle.net/20.500.11937/97664 |
| _version_ | 1848766299688140800 |
|---|---|
| author | Adewuyi, Emmanuel Akosile, W. Olutuase, V. Philip, A.A. Olaleru, R. Adewuyi, M.I. Auta, A. Khanal, V. |
| author_facet | Adewuyi, Emmanuel Akosile, W. Olutuase, V. Philip, A.A. Olaleru, R. Adewuyi, M.I. Auta, A. Khanal, V. |
| author_sort | Adewuyi, Emmanuel |
| building | Curtin Institutional Repository |
| collection | Online Access |
| description | Introduction: When medically indicated, caesarean section (CS) can be a life-saving intervention for mothers and their newborns. This study assesses the prevalence of CS and its associated factors, focussing on inequalities between rural and urban areas in Nigeria. Methods: We disaggregated the Nigeria Demographic and Health Survey 2018 and performed analyses separately for Nigeria’s overall, rural, and urban residences. We summarised data using frequency tabulations and identified factors associated with CS through multivariable logistic regression analysis. Results: CS prevalence was 2.7% in Nigeria (overall), 5.2% in urban and 1.2% in rural areas. The North-West region had the lowest prevalence of 0.7%, 1.5% and 0.4% for the overall, urban and rural areas, respectively. Mothers with higher education demonstrated a greater CS prevalence of 14.0% overall, 15.3% in urban and 9.7% in rural residences. Frequent internet use increased CS prevalence nationally (14.3%) and in urban (15.1%) and rural (10.1%) residences. The southern regions showed higher CS prevalence, with the South-West leading overall (7.0%) and in rural areas (3.3%), and the South-South highest in urban areas (8.5%). Across all residences, rich wealth index, maternal age ≥ 35, lower birth order, and ≥ eight antenatal (ANC) contacts increased the odds of a CS. In rural Nigeria, husbands’ education, spouses’ joint healthcare decisions, birth size, and unplanned pregnancy increased CS odds. In urban Nigeria, multiple births, Christianity, frequent internet use, and ease of getting permission to visit healthcare facilities were associated with higher likelihood of CS. Conclusion: CS utilisation remains low in Nigeria and varies across rural-urban, regional, and socioeconomic divides. Targeted interventions are imperative for uneducated and socioeconomically disadvantaged mothers across all regions, as well as for mothers in urban areas who adhere to Islam, traditional, or ‘other’ religions. Comprehensive intervention measures should prioritise educational opportunities and resources, especially for rural areas, awareness campaigns on the benefits of medically indicated CS, and engagement with community and religious leaders to promote acceptance using culturally and religiously sensitive approaches. Other practical strategies include promoting optimal ANC contacts, expanding internet access and digital literacy, especially for rural women (e.g., through community Wi-Fi programs), improving healthcare infrastructure and accessibility in regions with low CS prevalence, particularly in the North-West, and implementing socioeconomic empowerment programs, especially for women in rural areas. |
| first_indexed | 2025-11-14T11:48:57Z |
| format | Journal Article |
| id | curtin-20.500.11937-97664 |
| institution | Curtin University Malaysia |
| institution_category | Local University |
| language | eng |
| last_indexed | 2025-11-14T11:48:57Z |
| publishDate | 2024 |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | curtin-20.500.11937-976642025-05-03T08:11:38Z Caesarean section and associated factors in Nigeria: assessing inequalities between rural and urban areas—insights from the Nigeria Demographic and Health Survey 2018 Adewuyi, Emmanuel Akosile, W. Olutuase, V. Philip, A.A. Olaleru, R. Adewuyi, M.I. Auta, A. Khanal, V. Caesarean section Childbirth Emergency obstetric care Inequalities Maternal-child health Nigeria Rural-urban differences Humans Nigeria Female Rural Population Urban Population Adult Cesarean Section Pregnancy Young Adult Health Surveys Socioeconomic Factors Adolescent Middle Aged Prevalence Healthcare Disparities Educational Status Humans Cesarean Section Health Surveys Prevalence Pregnancy Socioeconomic Factors Adolescent Adult Middle Aged Rural Population Urban Population Educational Status Nigeria Female Healthcare Disparities Young Adult Introduction: When medically indicated, caesarean section (CS) can be a life-saving intervention for mothers and their newborns. This study assesses the prevalence of CS and its associated factors, focussing on inequalities between rural and urban areas in Nigeria. Methods: We disaggregated the Nigeria Demographic and Health Survey 2018 and performed analyses separately for Nigeria’s overall, rural, and urban residences. We summarised data using frequency tabulations and identified factors associated with CS through multivariable logistic regression analysis. Results: CS prevalence was 2.7% in Nigeria (overall), 5.2% in urban and 1.2% in rural areas. The North-West region had the lowest prevalence of 0.7%, 1.5% and 0.4% for the overall, urban and rural areas, respectively. Mothers with higher education demonstrated a greater CS prevalence of 14.0% overall, 15.3% in urban and 9.7% in rural residences. Frequent internet use increased CS prevalence nationally (14.3%) and in urban (15.1%) and rural (10.1%) residences. The southern regions showed higher CS prevalence, with the South-West leading overall (7.0%) and in rural areas (3.3%), and the South-South highest in urban areas (8.5%). Across all residences, rich wealth index, maternal age ≥ 35, lower birth order, and ≥ eight antenatal (ANC) contacts increased the odds of a CS. In rural Nigeria, husbands’ education, spouses’ joint healthcare decisions, birth size, and unplanned pregnancy increased CS odds. In urban Nigeria, multiple births, Christianity, frequent internet use, and ease of getting permission to visit healthcare facilities were associated with higher likelihood of CS. Conclusion: CS utilisation remains low in Nigeria and varies across rural-urban, regional, and socioeconomic divides. Targeted interventions are imperative for uneducated and socioeconomically disadvantaged mothers across all regions, as well as for mothers in urban areas who adhere to Islam, traditional, or ‘other’ religions. Comprehensive intervention measures should prioritise educational opportunities and resources, especially for rural areas, awareness campaigns on the benefits of medically indicated CS, and engagement with community and religious leaders to promote acceptance using culturally and religiously sensitive approaches. Other practical strategies include promoting optimal ANC contacts, expanding internet access and digital literacy, especially for rural women (e.g., through community Wi-Fi programs), improving healthcare infrastructure and accessibility in regions with low CS prevalence, particularly in the North-West, and implementing socioeconomic empowerment programs, especially for women in rural areas. 2024 Journal Article http://hdl.handle.net/20.500.11937/97664 10.1186/s12884-024-06722-6 eng unknown |
| spellingShingle | Caesarean section Childbirth Emergency obstetric care Inequalities Maternal-child health Nigeria Rural-urban differences Humans Nigeria Female Rural Population Urban Population Adult Cesarean Section Pregnancy Young Adult Health Surveys Socioeconomic Factors Adolescent Middle Aged Prevalence Healthcare Disparities Educational Status Humans Cesarean Section Health Surveys Prevalence Pregnancy Socioeconomic Factors Adolescent Adult Middle Aged Rural Population Urban Population Educational Status Nigeria Female Healthcare Disparities Young Adult Adewuyi, Emmanuel Akosile, W. Olutuase, V. Philip, A.A. Olaleru, R. Adewuyi, M.I. Auta, A. Khanal, V. Caesarean section and associated factors in Nigeria: assessing inequalities between rural and urban areas—insights from the Nigeria Demographic and Health Survey 2018 |
| title | Caesarean section and associated factors in Nigeria: assessing inequalities between rural and urban areas—insights from the Nigeria Demographic and Health Survey 2018 |
| title_full | Caesarean section and associated factors in Nigeria: assessing inequalities between rural and urban areas—insights from the Nigeria Demographic and Health Survey 2018 |
| title_fullStr | Caesarean section and associated factors in Nigeria: assessing inequalities between rural and urban areas—insights from the Nigeria Demographic and Health Survey 2018 |
| title_full_unstemmed | Caesarean section and associated factors in Nigeria: assessing inequalities between rural and urban areas—insights from the Nigeria Demographic and Health Survey 2018 |
| title_short | Caesarean section and associated factors in Nigeria: assessing inequalities between rural and urban areas—insights from the Nigeria Demographic and Health Survey 2018 |
| title_sort | caesarean section and associated factors in nigeria: assessing inequalities between rural and urban areas—insights from the nigeria demographic and health survey 2018 |
| topic | Caesarean section Childbirth Emergency obstetric care Inequalities Maternal-child health Nigeria Rural-urban differences Humans Nigeria Female Rural Population Urban Population Adult Cesarean Section Pregnancy Young Adult Health Surveys Socioeconomic Factors Adolescent Middle Aged Prevalence Healthcare Disparities Educational Status Humans Cesarean Section Health Surveys Prevalence Pregnancy Socioeconomic Factors Adolescent Adult Middle Aged Rural Population Urban Population Educational Status Nigeria Female Healthcare Disparities Young Adult |
| url | http://hdl.handle.net/20.500.11937/97664 |