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Factors contributing to socio-economic inequality in utilization of caesarean section delivery among women in Indonesia: Evidence from Demographic and Health Survey

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  • Pradeep Kumar
  • Shobhit Srivastava
  • Pratishtha Chaudhary
  • T Muhammad

Abstract

Background: Most of the existing literature in developing countries focused on either the rising trend of CS or its determinants. There is a paucity of population-based studies on existing socioeconomic inequalities in availing CS services by women in Indonesia. This study aimed to assess the factors associated with caesarian section (CS) delivery and explore the various factors contributing to inequalities in CS delivery rates in Indonesia. Methods: The study utilized nationally representative cross-sectional data from the Indonesia Demographic and Health Survey (IDHS), 2017. We conducted multivariable logistic regression to find the factors associated with CS delivery. Concentration index and Wagstaff’s decomposition analysis were used to examine the socioeconomic inequalities in CS delivery among women and associated factors. Results: About 17% of women in Indonesia delivered babies through CS. A concentration index of 0.31 in CS delivery rate showed a higher CS delivery rate among women belonging to rich households. About 44.7% of socioeconomic status inequality in CS delivery was explained by educational status among women who went for CS delivery. Women’s place of residence explained 30.1% of socioeconomic inequality, and women’s age at first birth explained about 11.9% and reporting ANC visits explained 8.4% of the observed inequality. Highest socioeconomic inequality was witnessed in central Sulawesi (0.529), followed by Maluku (0.488) and West Kalimantan (0.457), whereas the lowest was recorded in Yogyakarta (0.021) followed by north Sulawesi (0.047) and east Kalimantan (0.171). Education (44.7%) followed by rural-urban place of residence (30.1%) and age of first birth (11.9%) contributed most to explain the gap in CS delivery among rich and poor women. Conclusion: The study highlighted the higher CS delivery rates among women from higher socioeconomic groups and thus, it is important to frame policies after identifying the population subgroups with potential underuse or overuse of CS method of delivery.

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  • Pradeep Kumar & Shobhit Srivastava & Pratishtha Chaudhary & T Muhammad, 2023. "Factors contributing to socio-economic inequality in utilization of caesarean section delivery among women in Indonesia: Evidence from Demographic and Health Survey," PLOS ONE, Public Library of Science, vol. 18(9), pages 1-16, September.
    • Handle: RePEc:plo:pone00:0291485
    DOI: 10.1371/journal.pone.0291485
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    References listed on IDEAS

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    1. Thea van Roode & Katrina Sharples & Nigel Dickson & Charlotte Paul, 2017. "Life-Course Relationship between Socioeconomic Circumstances and Timing of First Birth in a Birth Cohort," PLOS ONE, Public Library of Science, vol. 12(1), pages 1-16, January.
    2. Lange, Isabelle L. & Kanhonou, Lydie & Goufodji, Sourou & Ronsmans, Carine & Filippi, Véronique, 2016. "The costs of ‘free’: Experiences of facility-based childbirth after Benin's caesarean section exemption policy," Social Science & Medicine, Elsevier, vol. 168(C), pages 53-62.
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