PDF(Pubmed)
Abstract：
BACKGROUND: 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.
CONCLUSIONS: 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.
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.
CONCLUSIONS: 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.
摘要：
背景：经医学证明，剖腹产（CS）可以挽救母亲及其新生儿的生命。这项研究评估了CS的患病率及其相关因素，关注尼日利亚农村和城市地区之间的不平等。
方法：我们对2018年尼日利亚人口和健康调查进行了分类，并分别对尼日利亚的总体情况进行了分析。农村,和城市住宅。我们使用频率表汇总数据，并通过多变量逻辑回归分析确定与CS相关的因素。
结果：尼日利亚的CS患病率为2.7％（总体），城市为5.2%，农村为1.2%。西北地区的患病率最低,为0.7%,整体为1.5%和0.4%，城市和农村地区，分别。受过高等教育的母亲表现出更高的CS患病率，总体为14.0％，城市住宅占15.3%，农村住宅占9.7%。频繁使用互联网增加了全国（14.3％）以及城市（15.1％）和农村（10.1％）居民的CS患病率。南部地区的CS患病率较高，西南地区总体领先(7.0%)，农村地区领先(3.3%)，城市地区的南南最高(8.5%)。在所有住宅中，丰富的财富指数，产妇年龄≥35岁，出生顺序较低，≥8次产前（ANC）接触增加了CS的几率。在尼日利亚农村,丈夫\'教育，配偶联合医疗决策，出生尺寸,和计划外怀孕增加CS的几率。在尼日利亚城市，多胎,基督教,经常使用互联网，并且获得访问医疗机构的许可容易与CS的可能性更高相关。
结论：尼日利亚的CS利用率仍然很低，并且在农村和城市之间有所不同，区域,和社会经济鸿沟。对所有地区未受过教育和社会经济上处于不利地位的母亲，必须采取有针对性的干预措施，以及城市地区坚持伊斯兰教的母亲，传统,或\'其他\'宗教。综合干预措施应优先考虑教育机会和资源，尤其是农村地区，关于医学上指示的CS益处的宣传运动，并与社区和宗教领袖接触，以使用文化和宗教敏感的方法促进接受。其他实际策略包括促进最佳的ANC联系，扩大互联网接入和数字素养，特别是对于农村妇女(例如，通过社区Wi-Fi计划)，改善低CS患病率地区的医疗基础设施和可及性，特别是在西北部，实施社会经济赋权计划，特别是农村地区的妇女。
方法：我们对2018年尼日利亚人口和健康调查进行了分类，并分别对尼日利亚的总体情况进行了分析。农村,和城市住宅。我们使用频率表汇总数据，并通过多变量逻辑回归分析确定与CS相关的因素。
结果：尼日利亚的CS患病率为2.7％（总体），城市为5.2%，农村为1.2%。西北地区的患病率最低,为0.7%,整体为1.5%和0.4%，城市和农村地区，分别。受过高等教育的母亲表现出更高的CS患病率，总体为14.0％，城市住宅占15.3%，农村住宅占9.7%。频繁使用互联网增加了全国（14.3％）以及城市（15.1％）和农村（10.1％）居民的CS患病率。南部地区的CS患病率较高，西南地区总体领先(7.0%)，农村地区领先(3.3%)，城市地区的南南最高(8.5%)。在所有住宅中，丰富的财富指数，产妇年龄≥35岁，出生顺序较低，≥8次产前（ANC）接触增加了CS的几率。在尼日利亚农村,丈夫\'教育，配偶联合医疗决策，出生尺寸,和计划外怀孕增加CS的几率。在尼日利亚城市，多胎,基督教,经常使用互联网，并且获得访问医疗机构的许可容易与CS的可能性更高相关。
结论：尼日利亚的CS利用率仍然很低，并且在农村和城市之间有所不同，区域,和社会经济鸿沟。对所有地区未受过教育和社会经济上处于不利地位的母亲，必须采取有针对性的干预措施，以及城市地区坚持伊斯兰教的母亲，传统,或\'其他\'宗教。综合干预措施应优先考虑教育机会和资源，尤其是农村地区，关于医学上指示的CS益处的宣传运动，并与社区和宗教领袖接触，以使用文化和宗教敏感的方法促进接受。其他实际策略包括促进最佳的ANC联系，扩大互联网接入和数字素养，特别是对于农村妇女(例如，通过社区Wi-Fi计划)，改善低CS患病率地区的医疗基础设施和可及性，特别是在西北部，实施社会经济赋权计划，特别是农村地区的妇女。
