Prevalence, indications and associated factors of cesarean section delivery at public hospitals  in Wolayta Zone Southern, Ethiopia

Background : Cesarean section is a common major operation performed on women in developing and developed parties.Today the cesarean section is alarmingly increasing in both low and middle-income countries while maternal morbidity and mortality could not be decreased at the expected level.The aim of this study was to assess the prevalence, indication and associated factors of cesarean section, in Wolayta Zone, Southern, Ethiopia. Methods: A hospital-based cross-sectional study was conducted from January 01-February 30, 2017 on a sample of 514 mothers who delivered at public hospitals in Wolayta Zone. The mothers were selected using systematic random sampling.The data were collected using structured and pretested interviewer-administered questionnaires at the postnatal ward of each hospital. Data entry and cleaning were done by using EPI Data3.5.1 and exported to SPSS version 20.0 software package for analysis.Bivariate and multivariable analyses were done to test the presence of association between dependent and independent variables. P-value < 0.05 was considered as statistically significant. Results : The result revealed that 29.8% (95% CI:25.9-33.7) of women who delivered at public hospitals were by Cesarean section. A woman who had unstable conditions during labor and women who followed by partograph had higher odds of cesarean section delivery .Whereas, women who live in urban, women who had previous pregnancy complications,women who had not current obstetric problems and the number of seniors less than two had lower odds of cesarean section delivery.Obstructed labor, fetal distress,cephalic pelvic disproportion, previous c/s scar, Antepartum hemorrhage, mal-presentation, big baby, failed induction or augmentation, twin pregnancy, and cord prolapse were the identified indications for cesarean section in Wolayta Zone. Conclusion: In this study, the prevalence of cesarean section was high compared to the WHO threshold. women who follow up by partograph had high odds of cesarean section delivery.The number of seniors greater than two had a significant effect on the reduction of the cesarean section. Hence,the hospital could be trained obstetric care providers proper plotting of partograph to decrease unnecessary cesarean section. Deployment of the above two seniors at the hospitals could be a reduced unnecessary cesarean section. Keywords: Prevalence, indication, associated factors, cesarean section, Ethiopia