Spatial and Socioeconomic Inequalities in Cesarean Section Deliveries in Urban Settings in Dakar, Senegal.

Autor: Sy I; Department of Geography, University Cheikh Anta Diop of Dakar (UCAD), Dakar, Senegal. ibrahima.ousmane.sy@gmail.com., Sandie AB; African Population and Health Research Center (APHRC), West Africa Regional Office, Dakar, Senegal., Sylla EM; African Population and Health Research Center (APHRC), West Africa Regional Office, Dakar, Senegal., Cissé B; Department of Geography, University Cheikh Anta Diop of Dakar (UCAD), Dakar, Senegal., Fall NA; African Population and Health Research Center (APHRC), West Africa Regional Office, Dakar, Senegal., Sow MO; Department of Geography, University Cheikh Anta Diop of Dakar (UCAD), Dakar, Senegal., Silla NB; African Population and Health Research Center (APHRC), West Africa Regional Office, Dakar, Senegal., Faye CM; African Population and Health Research Center (APHRC), West Africa Regional Office, Dakar, Senegal., Diène AN; Department of Geography, University Cheikh Anta Diop of Dakar (UCAD), Dakar, Senegal.
Jazyk: angličtina
Zdroj: Journal of urban health : bulletin of the New York Academy of Medicine [J Urban Health] 2024 Nov; Vol. 101 (Suppl 1), pp. 81-91. Date of Electronic Publication: 2024 Mar 20.
DOI: 10.1007/s11524-024-00835-1
Abstrakt: As part of an initiative aimed at reducing maternal and child mortality, Senegal implemented a policy of free Cesarean section (C-section) since 2005. Despite the implementation, C-section rates have remained low and significant large disparities in access, particularly in major cities such as Dakar. This paper aims to assess C-section rates and examines socioeconomic inequalities in C-section use in the Dakar region between 2005 and 2019. This study incorporates data from various sources, including the health routine data within District Health Information Software 2 (DHIS2) platform, government statistics on slum areas, and data from Demographic and Health Surveys (DHS). A geospatial analysis was conducted to identify locations of Comprehensive emergency obstetric and Newborn Care (CEmONC) services using the Direction des Travaux Géographiques et Cartographiques (DTGC) databases and satellite imagery from the Google Earth platform. The analytical approach encompassed univariate, bivariate, and multivariate analyses. The C-section rate fluctuated over the years, increasing from 11.1% in 2005 to 16.4% in 2011, declined to 9.8% in 2014, and then raised to 13.3% in 2019. The wealth tertile demonstrated a positive correlation with C-sections in urban areas of the Dakar region. Geospatial analyses revealed that women residing in slum areas were less likely to undergo C-section deliveries. These findings underscore the importance of public health policies extending beyond merely providing free C-section delivery services. Strategies that improve equitable access to C-section delivery services for women across all socioeconomic strata are needed, particularly targeting the poor women and those in urban slums.
(© 2024. The Author(s).)
Databáze: MEDLINE
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