Demand For Caesarean Delivery In Kenya

Abstract

Background. Caesarean delivery is a method of child birth whereby an incision is made through the abdominal muscles and uterine wall to remove the baby. Historically, it was done only if the mother had died before delivery. However, today, it is conducted either in emergency cases or if a mother chooses to. In 2013, the government of Kenya introduced a free maternal health policy aimed at increasing access to maternal health services, delivery included. This was therefore expected to increase the number of women delivering by Caesarean section in public hospitals in the country. It is however not well understood whether abolition of delivery fees alone is sufficient to cause such a policy outcome. This is the knowledge gap that this study seeks to fill. Objectives. The general objective of this study is to compare trends and predictors of Caesarian delivery between government owned and privately owned hospitals in Kenya. The specific objectives were to analyze the comparative trends of recorded Caesarian deliveries between public and private hospitals in Kenya since implementation of free maternal care policy, to determine the association between sociodemographic characteristics and likelihood of Caesarean delivery, to investigate the relationship between method of payment and choice of site for Caesarean delivery, to establish the influence of health facility characteristics on choice of site of Caesarean delivery and to determine contributors to Caesarean section deliveries in public hospitals as compared to private hospitals in Kenya using the modified Robson criteria Methodology. Mutivariable logistic regression analysis of secondary data from KDHS 2014 will be analysed on stata version 13. The independent variables of Age of Mother at Birth, Parity, Previous CS, Income, Mother’s level of education, Person assisting in the delivery, Distance to the nearest public health facility, Number of ANC visits, Method of payment, Residence (Urban, Rural), Region and Religion will be regressed in a logit model against the choice of site of Caesarean delivery as the dependent variable. A logit model equation will then be developed from the regression coefficients.