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Bull World Health Organ. 2013 Dec 1;91(12):914-922D. doi: 10.2471/BLT.13.117598. Epub 2013 Aug 9.

Trends in caesarean delivery by country and wealth quintile: cross-sectional surveys in southern Asia and sub-Saharan Africa.

Author information

1
London School of Hygiene & Tropical Medicine, Keppel Street, London WC1E 7HT, England .
2
Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil .

Abstract

in English, Arabic, Chinese, French, Russian, Spanish

OBJECTIVE:

To examine temporal trends in caesarean delivery rates in southern Asia and sub-Saharan Africa, by country and wealth quintile.

METHODS:

Cross-sectional data were extracted from the results of 80 Demographic and Health Surveys conducted in 26 countries in southern Asia or sub-Saharan Africa. Caesarean delivery rates were evaluated - as percentages of the deliveries that ended in live births - for each wealth quintile in each survey. The annual rates recorded for each country were then compared to see if they had increased over time.

FINDINGS:

Caesarean delivery rates had risen over time in all but 6 study countries but were consistently found to be lower than 5% in 18 of the countries and 10% or less in the other eight countries. Among the poorest 20% of the population, caesarean sections accounted for less than 1% and less than 2% of deliveries in 12 and 21 of the study countries, respectively. In each of 11 countries, the caesarean delivery rate in the poorest 40% of the population remained under 1%. In Chad, Ethiopia, Guinea, Madagascar, Mali, Mozambique, Niger and Nigeria, the rate remained under 1% in the poorest 80%. Compared with the 22 African study countries, the four study countries in southern Asia experienced a much greater rise in their caesarean delivery rates over time. However, the rates recorded among the poorest quintile in each of these countries consistently fell below 2%.

CONCLUSION:

Caesarean delivery rates among large sections of the population in sub-Saharan Africa are very low, probably because of poor access to such surgery.

PMID:
24347730
PMCID:
PMC3845270
DOI:
10.2471/BLT.13.117598
[Indexed for MEDLINE]
Free PMC Article

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