Bivariate Generalized Bernoulli Model for Analyzing Dependence between Antenatal Care and Cesarean Section Births

Type Thesis or Dissertation - Master of Science (Thesis) in Applied Statistics
Title Bivariate Generalized Bernoulli Model for Analyzing Dependence between Antenatal Care and Cesarean Section Births
Author(s)
Publication (Day/Month/Year) 2017
URL http://dspace.ewubd.edu/bitstream/handle/123456789/2129/Shafayatul_Islam_Shiblee.pdf?sequence=1&isAl​lowed=y
Abstract
Cesarean section delivery can prevent maternal and child mortality effectively. However,
if there is no medical necessity then it has no benefit. During the past two decades, cesarean
delivery has been increasing alarmingly both in developed and developing countries. Along
with clinical factors, Number of antenatal visits, Antenatal provider and Place of antenatal
care has influence on the increase of cesarean section delivery. In this study, the dependence
between antenatal care (i.e. number of antenatal visits, from whom received the antenatal
and place of antenatal care) and cesarean section delivery is assessed along with some
selected demographic-socioeconomic covariates by implying Generalized Bivariate
Bernoulli Model. Bangladesh Demographic and Health Survey, 2014 is used in this study
to illustrate the model. In this present study prevalence of cesarean delivery in Bangladesh
is 24%, though this rate varies from 12.1% to 34.4% in different divisions. Women with
advance age were more likely to have cesarean section (OR = 1.83, p-value = 0.01 and OR
= 2.84, p-value = 0.03 respectively for age groups “20-34” and “35-49”). Though the risk
was higher only if 4 or more than 4 antenatal visits were made and in case the care was
received from qualified doctor then women aged 20-34 years likely to have higher risk of
CS (OR = 1.79, p-value = 0.05). Higher risk of CS for this group was also found if antenatal
care was received from public or private sector (OR = 1.83, p-value = 0.03) and if the care
was received from home or NGO sector then women aged 35-49 years were more likely to
have CS compared to those aged <20 years.

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