| Geographic and socioeconomic inequalities in cesarean birth rates in Peru: A comparison between 2009 and 2018 |
| Authors: |
Akram Hernandez-Vasquez, Horacio Chacon-Torrico, and Guido Bendezu-Quispe |
| Source: |
Birth, DOI: 10.1111/birt.12572 |
| Topic(s): |
Cesarean section
Inequality
Spatial analysis
Wealth Index
|
| Country: |
Latin American/Caribbean
Peru
|
| Published: |
JUL 2021 |
| Abstract: |
Background: There is a global concern about the high rates of cesarean birth (CB). This study aimed to investigate the geographic and socioeconomic inequalities in CB rates in the Peruvian population.
Methods: We conducted a population-based study using the Peruvian Demographic and Family Health Surveys (ENDES, the Spanish acronym for Encuesta Demográfica y de Salud Familiar) between 2009 and 2018. ENDES reported data from births registered in the five years preceding survey execution. For the years 2009 (n = 10 289) and 2018 (n = 23 077), we calculated the weighted rates of CB among variables such as natural geographic domain (Coast, Andean, or Amazon), area of residence (rural or urban), wealth index quintile (quintile 1 is poorest, and quintile 5 is richest), and educational level. To assess inequalities, we calculated the concentration index (CIs), the slope index of inequality (SII), and the relative index of inequality (RII).
Results: The CB rates by year were 21.4% (95% confidence interval [CI]: 20.0-22.9) in 2009 and 34.5% (95% CI: 33.4-35.5) in 2018. Women living in urban and coastal regions and with a higher education level had the highest CB rates. All the CIs were positive, reflecting a prowealthy inequality in CB rates, and both SII and RII were positive, indicating a gap between the use of cesarean in women in the higher wealth quintile compared with those in the lower quintile.
Conclusions: Cesarean birth rates have increased by 60% during the last decade in Peru. The richest wealth quintiles had the highest CB rates during the study years, which were well above global recommendations. |
| Web: |
https://pubmed.ncbi.nlm.nih.gov/34240458/ |
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