Prevalence, Indications, and Community Perceptions of Caesarean Section Delivery in Ngora District, Eastern Uganda: Mixed Method Study.

IF 1.6 Q3 OBSTETRICS & GYNECOLOGY
Obstetrics and Gynecology International Pub Date : 2020-07-20 eCollection Date: 2020-01-01 DOI:10.1155/2020/5036260
Isaac Waniala, Sandra Nakiseka, Winnie Nambi, Isaac Naminya, Margret Osuban Ajeni, Jacob Iramiot, Rebecca Nekaka, Julius Nteziyaremye
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引用次数: 16

Abstract

Background: Uganda has a high maternal mortality ratio (MMR) of 336/100,000 live births. Caesarean section is fundamental in achieving equity and equality in emergency obstetric care services. Despite it being a lifesaving intervention, it is associated with risks. There has been a surge in caesarean section rates in some areas, yet others remain underserved. Studies have shown that rates exceeding 15% do not improve maternal and neonatal morbidity and mortality. Our study aimed at determining the prevalence, indications, and community perceptions of caesarean section delivery in Eastern Uganda.

Methods and materials: It was both health facility and commuity based cross-sectional descriptive study in Ngora district, Eastern Uganda. Mixed methods of data collection were employed in which quantitative data were collected by retrospectively reviewing all charts of all the mothers that had delivered at the two comprehensive emergency obstetric care service facilities between April 2018 and March 2019. Qualitative data were collected by focus group discussions till point of saturation. Data were entered into EpiData (version 3.1) and analyzed using SPSS software (version 24). Qualitative data analysis was done by transcribing and translating into English verbatim and then analyzed into themes and subthemes with the help of NVIVO 12.

Results: Of the total 2573 deliveries, 14% (357/2573) were by CS. The major single indications were obstructed labour 17.9%, fetal distress 15.3%, big baby 11.6%, and cephalopelvic disproportion (CPD) 11%. Although appreciated as lifesaving for young mothers, those with diseases and recurrent intrauterine fetal demise, others considered CS a curse, marriage-breaker, misfortune, money-maker and a sign of incompetent health workers, and being for the lazy women and the rich civil servants. The rise was also attributed to intramuscular injections and contraceptive use. Overall, vaginal delivery was the preferred route.

Conclusion: Several misconceptions that could hinder access to CS were found which calls for more counseling and male involvement. Although facility based, the rate is higher than the desired 5-15%. It is higher than the projected increase of 36% by 2021. It highlights the need for male involvement during counseling and consent for CS and concerted efforts to demystify community misconceptions about women that undergo CS. These misconceptions may be a hindrance to access to CS.

乌干达东部恩戈拉地区剖宫产的患病率、适应症和社区观念:混合方法研究。
背景:乌干达的产妇死亡率(MMR)很高,为336/10万活产。剖腹产对于实现产科急诊服务的公平和平等至关重要。尽管它是一种挽救生命的干预措施,但它与风险有关。在一些地区,剖腹产率激增,但其他地区仍然服务不足。研究表明,超过15%的比率并不能改善孕产妇和新生儿的发病率和死亡率。本研究旨在确定乌干达东部剖宫产的患病率、适应症和社区对剖宫产的看法。方法和材料:在乌干达东部恩戈拉县进行以卫生设施和社区为基础的横断面描述性研究。采用混合数据收集方法,通过回顾性审查2018年4月至2019年3月期间在两家综合产科急诊服务机构分娩的所有母亲的所有图表,收集定量数据。定性数据通过焦点小组讨论收集到饱和点。数据录入EpiData(3.1版本),使用SPSS软件(24版本)进行分析。定性数据分析是通过逐字抄录并翻译成英文,然后借助NVIVO 12进行主题和副主题分析。结果:2573例分娩中,14%(357/2573)采用CS分娩。主要的单一适应症为难产17.9%,胎儿窘迫15.3%,大婴儿11.6%,头骨盆失调(CPD) 11%。虽然被认为可以挽救年轻母亲、疾病患者和反复发生的宫内胎儿死亡的生命,但其他人认为CS是一种诅咒、婚姻破裂、不幸、赚钱的人,是卫生工作者无能的标志,是懒惰妇女和富有的公务员的标志。这一增长还归因于肌肉注射和避孕措施的使用。总体而言,阴道分娩是首选途径。结论:发现了一些可能阻碍CS获得的误解,需要更多的咨询和男性参与。虽然以设施为基础,但比率高于预期的5-15%。这比预计的到2021年36%的增长率要高。它强调了男性参与CS咨询和同意的必要性,并共同努力消除社会对女性接受CS的误解。这些误解可能会阻碍你接触CS。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Obstetrics and Gynecology International
Obstetrics and Gynecology International OBSTETRICS & GYNECOLOGY-
CiteScore
3.60
自引率
0.00%
发文量
26
审稿时长
19 weeks
期刊介绍: Obstetrics and Gynecology International is a peer-reviewed, Open Access journal that aims to provide a forum for scientists and clinical professionals working in obstetrics and gynecology. The journal publishes original research articles, review articles, and clinical studies related to obstetrics, maternal-fetal medicine, general gynecology, gynecologic oncology, uro-gynecology, reproductive medicine and infertility, reproductive endocrinology, and sexual medicine.
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