| dc.description.abstract | The district health information system (DHIS2) of 2020, reported the rate of CS
deliveries at Jaramogi Oginga Odinga Teaching and Referral Hospital (JOOTRH) at
21.6%, more than WHO ideal rate for caesarean section deliveries of 10-15%. This descriptive study investigated sociodemographic factors of pregnant women, medical and non-medical factors related to both the pregnant women and the hospital system that influence CS deliveries at JOOTRH in Kisumu County. A cross-sectional descriptive study design was employed were a stratified sampling technique was used to select a sample of 385 files from the 10,055 CS deliveries done in JOOTRH in the period 2011 to 2020, from which data was collected using a pre-designed form. Collected data was entered into computer spreadsheets, and SPSS software used to analyze it. Participant characteristics were summarized using descriptive statistics, and further inferential analysis done using Chi-square to detect association between various variables with indication for CS delivery, using SPSS v23 (α=0.05). Findings were further illustrated using tables and figures. The average CS rate for the period of the study was 19%, lowest in the 2013 (16.87%) and highest in year 2020 (21.63%). Of the demographic factors, only education (p= 0.018), employment (p=0.015), and mode of payment for CS (p=0.048) were significantly associated with CS indication. This study found no significant role for general medical history (p = 0.163), ANC attendance (p = 0.413), but a strong association with obstetric factors (p < 0.001), the greatest being a previous CS scar (31.4%). The findings of this study thus present evidence of increased CS rate, and identifies some associated factors, which allows for focused interventions. Kisumu County Government and the Ministry of Health should come up with polices and guidelines on how to control the increase of CS rate at JOOTRH, while strengthening good referral practices that will allow most deliveries at lower-level facilities across the county, which could be emulated in other parts of the country and beyond. This may include policies and guidelines on trial of labour after caesarean section (TOLAC) and vaginal birth after caesarean section (VBAC). | en |
