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Inequalities in caesarean section in Burundi: evidence from the Burundi Demographic and Health Surveys (2010–2016)

BACKGROUND: Despite caesarean section (CS) being a lifesaving intervention, there is a noticeable gap in providing this service, when necessary, between different population groups within a country. In Burundi, there is little information about CS coverage inequality and the change in provision of t...

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Autores principales: Yaya, Sanni, Zegeye, Betregiorgis, Idriss-Wheeler, Dina, Shibre, Gebretsadik
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7359587/
https://www.ncbi.nlm.nih.gov/pubmed/32664936
http://dx.doi.org/10.1186/s12913-020-05516-8
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author Yaya, Sanni
Zegeye, Betregiorgis
Idriss-Wheeler, Dina
Shibre, Gebretsadik
author_facet Yaya, Sanni
Zegeye, Betregiorgis
Idriss-Wheeler, Dina
Shibre, Gebretsadik
author_sort Yaya, Sanni
collection PubMed
description BACKGROUND: Despite caesarean section (CS) being a lifesaving intervention, there is a noticeable gap in providing this service, when necessary, between different population groups within a country. In Burundi, there is little information about CS coverage inequality and the change in provision of this service over time. Using a high-quality equity analysis approach, we aimed to document both magnitude and change of inequality in CS coverage in Burundi over 7 years to investigate disparities. METHODS: For this study, data were extracted from the 2010 and 2016 Burundi Demographic and Health Surveys (BDHS) and analyzed through the recently updated Health Equity Assessment Toolkit (HEAT) of the World Health Organization. CS delivery was disaggregated by four equity stratifiers, namely education, wealth, residence and sub-national region. For each equity stratifier, relative and absolute summary measures were calculated. We built a 95% uncertainty interval around the point estimate to determine statistical significance. MAIN FINDINGS: Disparity in CS was present in both survey years and increased over time. The disparity systematically favored wealthy women (SII = 10.53, 95% UI; 8.97, 12.10), women who were more educated (PAR = 8.89, 95% UI; 8.51, 9.26), women living in urban areas (D = 12.32, 95% UI; 9.00, 15.63) and some regions such as Bujumbura (PAR = 11.27, 95% UI; 10.52, 12.02). CONCLUSIONS: Burundi had not recorded any progress in ensuring equity regarding CS coverage between 2010 and 2016. It is important to launch interventions that promote justified use of CS among all subpopulations and discourage overuse among high income, more educated women and urban dwellers.
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spelling pubmed-73595872020-07-17 Inequalities in caesarean section in Burundi: evidence from the Burundi Demographic and Health Surveys (2010–2016) Yaya, Sanni Zegeye, Betregiorgis Idriss-Wheeler, Dina Shibre, Gebretsadik BMC Health Serv Res Research Article BACKGROUND: Despite caesarean section (CS) being a lifesaving intervention, there is a noticeable gap in providing this service, when necessary, between different population groups within a country. In Burundi, there is little information about CS coverage inequality and the change in provision of this service over time. Using a high-quality equity analysis approach, we aimed to document both magnitude and change of inequality in CS coverage in Burundi over 7 years to investigate disparities. METHODS: For this study, data were extracted from the 2010 and 2016 Burundi Demographic and Health Surveys (BDHS) and analyzed through the recently updated Health Equity Assessment Toolkit (HEAT) of the World Health Organization. CS delivery was disaggregated by four equity stratifiers, namely education, wealth, residence and sub-national region. For each equity stratifier, relative and absolute summary measures were calculated. We built a 95% uncertainty interval around the point estimate to determine statistical significance. MAIN FINDINGS: Disparity in CS was present in both survey years and increased over time. The disparity systematically favored wealthy women (SII = 10.53, 95% UI; 8.97, 12.10), women who were more educated (PAR = 8.89, 95% UI; 8.51, 9.26), women living in urban areas (D = 12.32, 95% UI; 9.00, 15.63) and some regions such as Bujumbura (PAR = 11.27, 95% UI; 10.52, 12.02). CONCLUSIONS: Burundi had not recorded any progress in ensuring equity regarding CS coverage between 2010 and 2016. It is important to launch interventions that promote justified use of CS among all subpopulations and discourage overuse among high income, more educated women and urban dwellers. BioMed Central 2020-07-14 /pmc/articles/PMC7359587/ /pubmed/32664936 http://dx.doi.org/10.1186/s12913-020-05516-8 Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research Article
Yaya, Sanni
Zegeye, Betregiorgis
Idriss-Wheeler, Dina
Shibre, Gebretsadik
Inequalities in caesarean section in Burundi: evidence from the Burundi Demographic and Health Surveys (2010–2016)
title Inequalities in caesarean section in Burundi: evidence from the Burundi Demographic and Health Surveys (2010–2016)
title_full Inequalities in caesarean section in Burundi: evidence from the Burundi Demographic and Health Surveys (2010–2016)
title_fullStr Inequalities in caesarean section in Burundi: evidence from the Burundi Demographic and Health Surveys (2010–2016)
title_full_unstemmed Inequalities in caesarean section in Burundi: evidence from the Burundi Demographic and Health Surveys (2010–2016)
title_short Inequalities in caesarean section in Burundi: evidence from the Burundi Demographic and Health Surveys (2010–2016)
title_sort inequalities in caesarean section in burundi: evidence from the burundi demographic and health surveys (2010–2016)
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7359587/
https://www.ncbi.nlm.nih.gov/pubmed/32664936
http://dx.doi.org/10.1186/s12913-020-05516-8
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