Rising cesarean section rates, a patient's perspective: experience from a high birth rate country.

PURPOSE OF INVESTIGATION: To investigate the effect of social class, education and antenatal care on cesarian section (CS) rate and women's preference for CS. MATERIALS AND METHODS: This is a descriptive study performed on 509 women attending postnatal clinics in three primary care units in Ismailia governorate, Egypt. The study performed via a structured questionnaire including questions related to background socio-demographic data, questions related to obstetrical history for the last pregnancy and delivery, and questions related to economic standards. RESULTS: The study included 266 participants (52.3%) that delivered by CS in their last delivery. CS rate was significantly higher in highly educated women and high economic standard. Only 29 (7.7%) reported that they had preferred CS as a method of delivery. Educational level and economic standards significantly affected the proportion of women preferring CS as a method of delivery (p = 0.02 and p = 0.01, respectively). In a stepwise logistic regression model, significant factors affecting CS rate were: the method of delivery preferred (p < 0.005) and educational level (p < 0.05). CONCLUSION: Educational level and economic standards significantly affected women's preference towards CS and CS rate.

Reweighting DHS data to serve multiple perspectives.

Information about health and family planning infrastructures is collected through the service availability module (SAM), an important feature of the Demographic and Health Surveys (DHS) conducted in many developing countries. The DHS samples were designed to provide a representative sample of households and women of reproductive age. Using the weights routinely provided with DHS data sets, service accessibility can be described straightforwardly at the individual and household levels. However, without further adjustment, SAM data do not provide a representative picture of service delivery at the community, or primary sampling unit, level, where the data are collected. This report proposes a methodology for reweighting the SAM data, using rural data from the Egypt DHS as an illustration, so that available family planning facilities at this level may be usefully characterized at little additional cost.