ArticleBMJ open2018
Caesarean section provision and readiness in Tanzania: analysis of cross-sectional surveys of women and health facilities over time.
Article in BMJ open, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
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Who cites it
16 citing papers in PubMed.
- Trial
- Estimating the prevalence of vaginal birth after cesarean section and repeat cesarean section: An analysis of nationally representative household surveys in 59 low- and middle-income countries.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2026Article
- Use of explainable machine learning in risk classification of Cesarean section delivery: A cross-sectional analysis of Demographic and Health Surveys from ten Sub-Saharan African countries (2016-2024).PLOS global public health · 2026Article
- Research and Learning Priorities for a Surgical Obstetrics and Family Planning Project Implementing in Low- and Middle-Income Countries: Results of an Expert Consultation.Global health, science and practice · 2025Article
- Changes in Health Facility Readiness for Providing Quality Maternal and Newborn Care After Implementing the Safer Births Bundle of Care Package in Five Regions of Tanzania.Healthcare (Basel, Switzerland) · 2025Article
- A Systematic Review of Government-Led Free Caesarean Section Policies in Low- and Middle-Income Countries from 2009 to 2025.Healthcare (Basel, Switzerland) · 2025Review
- Prevalence and factors associated with caesarean section among Tanzanian women of reproductive age: evidence from the 2022 Tanzania demographic and health survey data.BMC public health · 2025Article
- Article
- Caesarean sections among east African refugees and their host population: a 20-year retrospective study in western Tanzania.African health sciences · 2024Article
- Readiness to provide comprehensive emergency obstetric and neonatal care: a cross-sectional study in 30 health facilities in Tanzania.BMC health services research · 2024Article
- Maternal interventions to decrease stillbirths and neonatal mortality in Tanzania: evidence from the 2017-18 cross-sectional Tanzania verbal and social autopsy study.BMC pregnancy and childbirth · 2023Article
- A small area model to assess temporal trends and sub-national disparities in healthcare quality.Nature communications · 2023Article
- Shared decision making on mode of delivery following a prior cesarean delivery in Dar es Salaam, Tanzania.PloS one · 2023Article
- Iatrogenic genito-urinary fistula following cesarean birth in nine sub-Saharan African countries: a retrospective review.BMC pregnancy and childbirth · 2022Article
- Association between first birth caesarean delivery and adverse maternal-perinatal outcomes in the second pregnancy: a registry-based study in Northern Tanzania.BMC pregnancy and childbirth · 2022Article
- Rationale of indications for caesarean delivery and associated factors among primigravidae in Tanzania.Journal of Taibah University Medical Sciences · 2021Article
Corrections and comments
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Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo describe trends in caesarean sections and facilities performing caesareans over time in Tanzania and examine the readiness of such facilities in terms of infrastructure, equipment and staffing.
designNationally representative, repeated cross-sectional surveys of women and health facilities.
settingTanzania.
participantsWomen of reproductive age and health facility staff.
main outcome measuresPopulation-based caesarean rate, absolute annual number of caesareans, percentage of facilities reporting to perform caesareans and three readiness indicators for safe caesarean care: availability of consistent electricity, 24 hour schedule for caesarean and anaesthesia providers, and availability of all general anaesthesia equipment.
resultsThe caesarean rate in Tanzania increased threefold from 2% in 1996 to 6% in 2015-16, while the total number of births increased by 60%. As a result, the absolute number of caesareans increased almost fivefold to 120 000 caesareans per year. The main mechanism sustaining the increase in caesareans was the doubling of median caesarean volume among public hospitals, from 17 caesareans per month in 2006 to 35 in 2014-15. The number of facilities performing caesareans increased only modestly over the same period. Less than half (43%) of caesareans in Tanzania in 2014-15 were performed in facilities meeting the three readiness indicators. Consistent electricity was widely available, and 24 hour schedules for caesarean and (less systematically) anaesthesia providers were observed in most facilities; however, the availability of all general anaesthesia equipment was the least commonly reported indicator, present in only 44% of all facilities (34% of public hospitals).
conclusionsGiven the rising trend in numbers of caesareans, urgent improvements in the availability of general anaesthesia equipment and trained anaesthesia staff should be made to ensure the safety of caesareans. Initial efforts should focus on improving anaesthesia provision in public and faith-based organisation hospitals, which together perform more than 90% of all caesareans in Tanzania.
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