المؤلفون: Jadoon B; World Health Organization Regional Office for the Eastern Mediterranean, Cairo, Egypt., Mahaini R; World Health Organization Regional Office for the Eastern Mediterranean, Cairo, Egypt., Gholbzouri K; World Health Organization Regional Office for the Eastern Mediterranean, Cairo, Egypt.

المصدر: Eastern Mediterranean health journal = La revue de sante de la Mediterranee orientale = al-Majallah al-sihhiyah li-sharq al-mutawassit [East Mediterr Health J] 2019 Nov 25; Vol. 25 (11), pp. 837-846. Date of Electronic Publication: 2019 Nov 25.

نوع المنشور: Journal Article; Systematic Review

بيانات الدورية: Publisher: Eastern Mediterranean Regional Office of the World Health Organization Country of Publication: Egypt NLM ID: 9608387 Publication Model: Electronic Cited Medium: Internet ISSN: 1687-1634 (Electronic) Linking ISSN: 10203397 NLM ISO Abbreviation: East Mediterr Health J Subsets: MEDLINE

مواضيع طبية MeSH: Cesarean Section/*statistics & numerical data , Health Services Misuse/*statistics & numerical data, Adolescent ; Adult ; Africa, Northern ; Age Factors ; Cultural Characteristics ; Health Services Accessibility/statistics & numerical data ; Humans ; Middle East ; Residence Characteristics ; Socioeconomic Factors ; Young Adult

مستخلص: Background: The World Health Organization (WHO) Eastern Mediterranean Region shows a huge disparity in caesarean birth practice among its 22 Member States. Little research has been conducted at the Regional level to determine the underlying causes.
Aims: This study aimed at exploring the available evidence on key determinants of high and low caesarean birth rates in the Region.
Methods: A scoping literature review was performed. We searched PubMed and Medline with keywords "determinants of caesarean birth/caesarean section" and "caesarean birth/caesarean section trend" in the Region during 2000-2017. We included cohort studies, case-control studies, systematic reviews and reviews published in peer-reviewed journals. Latest data about demographics and socioeconomic indicators of maternal and child health care were extracted from demographic health surveys and situational analyses from Member States and WHO Statistics 2015. Fifty-seven of 395 studies met the inclusion criteria. These determinants were discussed in a conceptual framework based on Andersen's Behavioral Model of Health Services Use, 2001.
Results: Lack of access to facility-based delivery and absence of skilled birth attendants were mainly responsible for the low caesarean birth rate in the Region. Social, cultural, individual and institutional factors affecting women's choice for childbirth have contributed to the high caesarean birth rate.
Conclusion: A multidimensional approach is required to explore these determinants to optimize the Regional caesarean birth rate. Further qualitative studies are needed to investigate how these factors affect choice of birthing process in specific cultural settings in the Region.
(Copyright © World Health Organization (WHO) 2019. Some rights reserved. This work is available under the CC BY-NC-SA 3.0 IGO license (https://creativecommons.org/licenses/by-nc-sa/3.0/igo).)