Table 1.
Trends in inequalities of CSRs in Indonesia from 1997 to 2017
| Caesarean section trends | 1991 (N=10995) | 1994 (N=13 147) | 1997 (N=13 276) | 2002 (N=12 974) | 2007 (N=14 934) | 2012 (N=14 866) | 2017 (N=15 029) |
| % | % | % | % | % | % | % | |
| CSR | 1.6 (1.3–1.9) | 2.7 (2.3–3.1) | 4.7 (4.1–5.4) | 4.1 (3.5–4.9) | 7.2 (6.5–8.1) | 12.7 (11.8–13.7) | 17.6 (16.7–18.5) |
| Place of birth | |||||||
| Public facility | 7.1 (5.3–9.3) | 11.2 (8.8–14.1) | 14.3 (11.9–17.2) | 15.0 (12.0–18.6) | 21.1 (18.3–24.2) | 25.3 (22.9–27.8) | 21.6 (20.1–23.1) |
| Private facility | 3.6 (2.5–5.0) | 7.3 (5.3–10.1) | 9.2 (7.4–11.4) | 8.7 (7.0–10.7) | 13.6 (11.8–15.5) | 17.5 (16.1–19.1) | 22.0 (20.6–23.4) |
| Difference (% (public–private)) | 3.5 (1.3–5.6) | 3.8 (0.4–7.2) | 5.1 (1.8–8.5) | 6.3 (2.5–10.2) | 7.5 (3.9–11.1) | 7.8 (5.0–10.6) | −0.4 (-2.4–1.6) |
| Ratio (public:private) | 2.0 (1.2–2.8) | 1.5 (0.9–2.1) | 1.6 (1.1–2.0) | 1.7 (1.2–2.3) | 1.6 (1.2–1.9) | 1.4 (1.3–1.6) | 1.0 (0.9–1.1) |
| Region of residence* | |||||||
| Java and Bali | NA | 2.6 (2.0–3.3) | 5.4 (4.4–6.6) | 4.9 (3.9–6.0) | 8.1 (6.9–9.4) | 13.7 (12.3–15.3) | 18.8 (17.4–20.2) |
| Sumatera | NA | 3.1 (2.4–3.9) | 3.9 (3.2–4.7) | 4.0 (3.1–5.2) | 6.6 (5.6–7.9) | 14.2 (12.9–15.7) | 19.4 (17.9–21.1) |
| Nusa Tenggara | NA | 1.5 (0.8–2.7) | 2.5 (1.6–4.0) | 1.1 (0.6–2.3) | 6.3 (4.5–8.7) | 8.0 (6.0–10.5) | 10.0 (7.9–12.4) |
| Kalimantan | NA | 2.5 (1.8–3.4) | 4.2 (2.8–6.1) | 2.2 (1.5–3.1) | 7.1 (5.5–9.0) | 9.2 (7.6–11.1) | 13.6 (11.3–16.2) |
| Sulawesi | NA | 3.0 (2.1–4.1) | 3.8 (2.9–5.0) | 2.3 (1.4–3.9) | 4.6 (3.7–5.7) | 8.9 (7.5–10.5) | 14.1 (12.2–16.3) |
| Maluku and Papua | NA | 2.3 (1.5–3.6) | 3.6 (2.2–5.8) | NA | 4.1 (2.7–6.3) | 6.3 (5.1–7.7) | 9.5 (7.3–12.1) |
| Difference (% (Java and Bali–Maluku and Papua) | NA | 0.3 (-0.9–1.4) | 1.8 (-0.2–3.9) | NA | 4.0 (1.8–6.2) | 7.4 (5.5–9.4) | 9.3 (6.6–12.1) |
| Ratio (Java and Bali: Maluku and Papua) | NA | 1.1 (0.6–1.7) | 1.5 (0.7–2.3) | NA | 2.0 (1.1–2.9) | 2.2 (1.7–2.7) | 2.0 (1.5–2.5) |
| Place of residence | |||||||
| Urban | 3.1 (2.4–4.1) | 4.9 (3.9–6.2) | 6.8 (5.8–8.1) | 6.7 (5.5–8.1) | 11.6 (10.2–13.2) | 17.0 (15.5–18.7) | 23.1 (21.7–24.5) |
| Rural | 0.9 (0.7–1.2) | 1.7 (1.4–2.2) | 3.9 (3.2–4.8) | 1.9 (1.4–2.5) | 4.0 (3.3–5.0) | 8.5 (7.5–9.5) | 12.4 (11.3–13.6) |
| Difference (% (urban–rural)) | 2.2 (1.3–3.1) | 3.2 (2.0–4.4) | 2.9 (1.5–4.4) | 4.8 (3.4–6.3) | 7.6 (5.9–9.3) | 8.6 (6.7–10.4) | 10.7 (8.9–12.5) |
| Ratio (urban:rural) | 3.4 (2.1–4.6) | 2.8 (1.9–3.8) | 1.8 (1.3–2.2) | 3.6 (2.3–4.9) | 2.9 (2.2–3.6) | 2.0 (1.7–2.3) | 1.9 (1.7–2.1) |
| Wealth quintiles | |||||||
| Q1 (poorest) | 0.9 (0.5–1.6) | 1.2 (0.7–1.9) | 3.2 (1.9–5.1) | 0.8 (0.4–1.7) | 1.9 (1.3–2.7) | 4.2 (3.4–5.1) | 6.5 (5.6–7.6) |
| Q2 | 0.7 (0.4–1.3) | 1.4 (0.8–2.3) | 4.1 (2.9–5.8) | 0.8 (0.5–1.3) | 4.7 (3.4–6.4) | 9.1 (7.7–10.7) | 11.7 (10.3–13.2) |
| Q3 | 1.0 (0.6–1.7) | 2.5 (1.8–3.6) | 3.9 (2.8–5.3) | 2.0 (1.3–3.2) | 4.9 (3.7–6.3) | 11.4 (9.8–13.2) | 15.6 (14.0–17.3) |
| Q4 | 1.8 (1.3–2.6) | 2.3 (1.6–3.4) | 4.4 (3.4–5.6) | 4.8 (3.6–6.4) | 7.6 (6.4–9.1) | 15.5 (13.7–17.4) | 22.6 (20.7–24.7) |
| Q5 (richest) | 3.4 (2.5–4.5) | 5.5 (4.3–7.0) | 7.8 (6.5–9.3) | 13.2 (10.9–15.9) | 17.9 (15.4–20.7) | 24.0 (21.5–26.7) | 32.1 (29.9–34.5) |
| Difference (% (richest–poorest)) | 2.5 (1.4–3.6) | 4.4 (3.0–5.8) | 4.6 (2.5–6.8) | 12.3 (9.8–14.9) | 16.0 (13.2–18.7) | 19.8 (17.0–22.5) | 25.6 (23.1–28.2) |
| Ratio (richest:poorest) | 3.9 (1.3–6.5) | 4.8 (2.3–7.3) | 2.5 (1.1–3.8) | 15.7 (4.6–26.8) | 9.5 (5.7–13.3) | 5.7 (4.4–7.0) | 4.9 (4.1–5.8) |
| Maternal education | |||||||
| No education and primary† | 1.1 (0.9–1.5) | 1.7 (1.3–2.1) | 3.8 (3.1–4.8) | 1.7 (1.2–2.4) | 2.9 (2.3–3.7) | 6.9 (5.9–8.1) | 9.3 (8.2–10.6) |
| Secondary | 2.8 (2.1–3.8) | 4.4 (3.6–5.4) | 5.6 (4.7–6.8) | 5.2 (4.2–6.3) | 8.4 (7.5–9.5) | 13.3 (12.2–14.5) | 17.4 (16.3–18.5) |
| Higher | 5.8 (3.1–10.5) | 11.7 (7.8–17.1) | 13.8 (10.4–18.1) | 18.5 (14.3–23.5) | 24.3 (20.1–29.1) | 26.5 (23.6–29.6) | 33.4 (31.1–35.7) |
| Difference (% (higher–noedu and primary)) | 4.7 (1.0–8.3) | 10.0 (5.5–14.5) | 10.0 (6.1–13.9) | 16.8 (12.1–21.4) | 21.4 (16.8–26.0) | 19.7 (16.4–22.9) | 24.0 (21.4–26.7) |
| Ratio (higher: noedu and primary) | 5.1 (1.7–8.6) | 7.0 (3.9–10.1) | 3.6 (2.3–4.9) | 11.0 (6.2–15.8) | 8.4 (5.8–11.1) | 3.9 (3.1–4.6) | 3.6 (3.1–4.1) |
*The region classification in 1991 is not detailed, which makes it incomparable to other years. Furthermore, there are no observations of CSRs found in Papua and Maluku in 2002 dataset. A note from Indonesia DHS Report in 2002 mentioned that ‘Due to security reasons, four provinces were excluded: Nanggroe Aceh Darussalam, Maluku, North Maluku, and Papua’72.
†No education and primary is a group of women without education or with partial/completed attendance of primary education.
CSR, caesarean section rate.