Determinants of Demand for Cesarean Section Delivery at the Ledzokuku-Krowor Municipal Assembly (LEKMA) Hospital

Abstract

The rise in caesarean section births has been a major source of concern for public health officials around the world. In most countries, the caesarean section rate (CSR) has gone above the World Health Organization's (WHO) recommended range of 10–16%. The Ghana Demographic and Health Survey, 2016-2021, Greater Accra region had the highest rate of Cesarean section(CS) deliveries (30%). Ledzokuku Municipal Assembly (LEMA) Hospital serving more clients. The specific objectives of the study were to: determine the proportion of Cesarean Section Rate (CSR) among mothers at LEKMA hospital and to assess factors associated with the demand for Cesarean Section delivery. The study design was an analytical cross-sectional study and the mixed method approach was used, to quantitatively and qualitatively generate primary and secondary data for analysis. The study population included mothers visiting the antenatal and post-natal care and health managers of the facility. A sample size of 374 of which 40 women attending the antenatal and postnatal clinic at the facility were interviewed and questionnaire was administered to 30 health managers. The inferential analysis was used to determine the predictors of the demand for CS. Over one-third of mothers 34% (130) were between 26-30 years of age and were married. In addition, 36% (136) of mothers were traders, hairdressers/seamstress and artisans. Also, less than one-third 27% (101) of mothers had secondary level education. The proportion of cesarean sections were 61% (55) elective with maternal conditions due to fetal conditions constituting 35% (39). Availability of obstetrician or gynecologist and maternal condition were found to be key determinants for the rise in CS at the facility. The study concludes that the rate of Cesarean Sections is 6 times the recommended and acceptable level of CS by the World Health Organization and the factors that influence the rise in CS rate at the facility are due to maternal conditions. Efforts should be made to improve services that would improve upon vaginal deliveries.