The Influence of Personal and Socioeconomic Factors on the Demand for Caesarean Section among Female Healthcare Workers at the Komfo Anokye Teaching Hospital, Kath

Abstract

Introduction: There has been increase in the Demand for Caesarean Section (CS) or Caesarean Delivery on Maternal Request (CDMR) in recent years with increasing financial and resource burden on health care delivery especially in resource poor settings including Ghana. This study was conducted to ascertain the factors influencing the demand for Caesarean delivery among female health workers at the Komfo Anokye Teaching Hospital, Kumasi. The objectives of the study were to find out the impact of Personal and Socioeconomic factors on the demand of caesarean section. Methods: The study was a descriptive cross-sectional conducted among 351 randomly selected female health staff from the Komfo Anokye Teaching Hospital. Data was captured with the use of questionnaires and analysed using descriptive statistics. Results and Findings: Almost 3 in 10 (27.7%) of health workers delivered through Cesarean Section. Fourteen percent indicated that they would willingly demand for CS for several reasons; with “avoiding labor pains” as the most cited reason. Factors that influenced demand for CS were negative birth experiences (OR=3.9; 95% CI=0.4, 29.6) and having problems during pregnancy (OR=17.9; p<0.001), mothers’ income or ability to pay (OR=2.6; p=0.01), spousal influence (23.7%), level of education (23.2%) and sexually satisfying spouse (18.9%). Others were availability of competent specialist/staff, 49.6%, advanced technology, 24.1% and success stories of CS from peers (26.3%) and belonging to the National Health Insurance scheme (OR=12.7; p<0.001), human resource capacity (OR=8.3; p<0.001) and being a health staff (OR=2.7; 95% CI=1.2, 5.7; p=0.01). Conclusion: Some Healthcare workers 14% (49) indicated they would demand CS.   Understanding women’s reasons behind demanding for CS is necessary to avoid unnecessary CS and help to channel the resources involved to other pertinent areas of health delivery.