Determinants of caesarean section delivery: a nationwide study in Indonesia
The number of caesarean section deliveries among mothers in Indonesia has increased every year.
This study was conducted to identify the prevalence and determinants of caesarean section in Indonesia.
A cross-sectional design using the 2017 Indonesian Demographic Health Survey was conducted. A total of 12 789 mothers were recruited, and bivariate analysis and binary logistic regression were used.
The determinants among women that were significant factors in performing caesarian section deliveries were maternal age >35 years, urban residence, high level of education, poorest wealth index, having more than four visits to antenatal care centres, close proximity to health facilities and first-time birth.
The rate of caesarean section deliveries in Indonesia was 17.7%. Monitoring and evaluation of the increasing number of caesarean sections without medical necessity and the severity of labour is needed.
Reducing maternal mortality remains a major challenge for healthcare systems worldwide. Indonesia has achieved the fourth target of the Millennium Development Goals, to reduce child mortality, but has yet to reach the fifth target, to improve maternal health by reducing the maternal mortality ratio and achieving universal access to reproductive health (Schröders et al, 2015). Problems with maternal and child healthcare are still prevalent in Indonesia. The government has carried out various programmes to improve maternal and child healthcare, one of which requires childbirth to be assisted by competent health personnel (Mahendradhata et al, 2017). This is an effort to achieve the sustainable development goal target of reducing the global maternal mortality rate to less than 70 per 100 000 live births by 2030 (World Health Organization (WHO), 2016a). Type of delivery, including caesarean section, can reduce maternal and infant mortality and delivery complications. However, a caesarean section is generally only performed according to planned medical situations that indicate its necessity, in an emergency setting or electively.
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