Abstract:
Introduction: Cesarean section (CS) prevalence rate has been in an alarming increase
worldwide each year; there are large disparities of CS proportion among women who
give birth at public and private health facility. However, the underlying factors and
proportion of CS delivery in public and private institutions are not well-known
Objective of the study: The aims of this study was to asses and compare proportion
of CS delivery and associated factors among public and private health facilities
delivered mother in Bahir Dar city, Amhara region, Ethiopia,
Methods: Institution based comparative cross-sectional study design was conducted
from March1-April 15, 2019 in Bahir Dar city. Study participants 724(362 for each group)
were recruited through systematic sampling technique. Structured interview
administered questionnaires and chart review checklist were used to collect data. The
data were entered with Epi info version 7.2 and analyzed using SPSS version23.0
software. A binary logistic regression model was fitted. Adjusted odds ration with 95%
CI was used to determine the presence and strength of association between
independent variables and cesarean section delivery.
Results: The response rate was 98.3% and 97.2% for public and private health facilities
respectively. The proportion of CS in private health facilities was198 (56.3%) (95%CI:
50.9, 61.4) and 98 (27.5%) (95%CI: 22.8, 32.2) was in public health facilities. Overall
proportion of CS delivery was 296(41.8%) (95% CI: 38.4, 45.5). Breech presentation
(AOR=3.64; 95%CI (1.49, 8.89), urban residence (AOR=6.54; 95%CI (2.59, 16.48) and
being referred (AOR=2.44; 95%CI (1.46, 4.08)were variables significantly associated
with CS among public whereas in private health facility: age between 15-24 (AOR=0.20,
95% CI; 0.07,0.52),governmental employee (AOR=2.28;95%CI (1.39,3.75), selfemployed
(AOR=3.73;95%CI(1.62,8.59),para one(AOR=6.79;95%CI(2.02,22.79) para
two (AOR=3.88;95% CI(1.15,13.08) , and wealth index being highest level of wealth
asset AOR=5.39; 95%CI (1.08, 26.8).
Conclusion and recommendation: We concluded that there is a statistically significant
difference on the proportion of CS delivery among public and private health facilities.
Therefore, there should be a mechanism for medical audit of labor management.
Key words: Public health facility, Private health facility, Cesarean section deliver
