Muhammad Zeeshan, Anam Iqbal, Sajid Rasul, Isaac Shahzad, Shaista Ashraf, Atif Akbar.
Prevalence and associated factors of caesarean section in Punjab, Pakistan: evidence from multiple indicators cluster survey, (2017-18) Punjab.
Pak J Med Res Jan ;60(2):62-8.

Background: Caesarean section was one of the major issues in worldwide both in developed and developing countries. In Punjab, high prevalence of C-section had been perceived. Objective: To assess the prevalence, socio-demographic and socio-economic factors of caesarean section in the Punjab. Methodology: The study was based on the data of Multiple Indicators Cluster Survey 2017-18 (MICS Punjab). Two-stage, stratified cluster sampling technique was adopted. Almost 53,840 households were selected to obtain the data from Punjab. Target population was currently and ever married women (15,656) who have given birth in last two years. From these women, a question was asked whether the delivery was normal or by C-section. We gave value 1 if delivered by C-section and 2 otherwise by using the Statistical Package for Social Sciences (SPSS) version 23. Results: The prevalence of C-section was 28.9% in the Punjab with 95% C.I (28.9%, 29.7%) and odds ratio (OR) 3.13. Out of ten, three women delivered baby by C-section. Area of residence, number of antenatal care visits, mother’s age at time of marriage, education, wealth index quintile, and tetanus toxoid injection during last pregnancy were highly associated with the C-section. Educated and rich women were more attracted to deliver by C-section as compare to a women who were uneducated and belonged to poor socioeconomic group. In Central Punjab higher cases were found as compare to the South Punjab and Northern Punjab. Conclusion: The prevalence of C-sections is very high in Punjab when compared with WHO standard. The contributing factors to this rising trend of increased rate of C-section, higher education, improvement of socioeconomic status and easy accessibility of C-section facilities. Key words: Caesarean section, age of marriage, multiple indicator cluster survey.

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