ArticlePloS one2021
Trends, wealth inequalities and the role of the private sector in caesarean section in the Middle East and North Africa: A repeat cross-sectional analysis of population-based surveys.
Article in PloS one, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 2 of them syntheses that pooled it.
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Who cites it
11 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Associations between maternal overweight and obesity with cesarean section delivery in Middle East and North Africa region: a systematic review, meta-analysis, and attributable risk.Systematic reviews · 2025Pooled it
- Caesarean delivery and its association with educational attainment, wealth index, and place of residence in Sub-Saharan Africa: a meta-analysis.Scientific reports · 2022Pooled it
- 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
- "Predictors of failed vaginal birth after cesarean and associated maternal and neonatal outcomes: a case control study".BMC pregnancy and childbirth · 2026Article
- Regional and demographic disparities in low-risk hospital deliveries in Brazil's Public Health System.Einstein (Sao Paulo, Brazil) · 2026Article
- Vacuum-Assisted Delivery and Neonatal Intensive Care Unit Admission: A Retrospective Case-Control Study at a Lebanese Hospital.International journal of pediatrics · 2026Article
- Article
- Variations in the prevalence of caesarean section deliveries in India between 2016 and 2021 - an analysis of Tamil Nadu and Chhattisgarh.BMC pregnancy and childbirth · 2023Article
- A Proposed Global Medicines Agency (GMA) to Make Biological Drugs Accessible: Starting with the League of Arab States.Healthcare (Basel, Switzerland) · 2023Review
- Quality of maternal and newborn health care at private hospitals in Iraq: a cross-sectional study.BMC pregnancy and childbirth · 2023Article
- Evolution of cesarean sections in Colombia and its association with the legal standing of the institutions where deliveries take placeRevista colombiana de obstetricia y ginecologia · 2023Article
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo examine trends and variations of caesarean section by economic status and type of healthcare facility in Arab countries in the Middle East and North Africa (MENA).
methodsSecondary data analysis of nationally representative household surveys conducted between 2008-2020 across nine Arab countries in the MENA region. The study population was women aged 15-49 years with a live birth in the two years preceding the survey. Temporal changes in the proportion of deliveries by caesarean section in each country were calculated using generalised linear models and presented as risk differences (RD) with 95% confidence intervals (95%CI). Caesarean section was disaggregated by household wealth index and type of healthcare facility.
resultsUse of caesarean section ranged from 57.3% (95%CI:55.6-59.1%) in Egypt to 5.7% of births (95%CI:4.9-6.6%) in Yemen. Overall, the use of caesarean section has increased across the MENA region, except in Jordan, where there was no evidence of change (RD -2.3 (95%CI: -6.0 ‒1.4)). Across most countries, caesarean section use was highest in the richest quintile compared to the poorest quintile, for example, 42.8% (95%CI:38.0-47.6%) vs. 22.6% (95%CI:19.6-25.9%) in Iraq, respectively. Proportion of caesarean section was higher in private sector facilities compared to public sector: 21.8% (95%CI:18.2-25.9%) vs. 15.7% (95%CI:13.3-18.4%) in Yemen, respectively.
conclusionVariations in caesarean section exist within and between Arab countries, and it was more commonly used amongst the richest quintiles and in private healthcare facilities. The private sector has a prominent role in observed trends. Urgent policies and interventions are required to address non-medically indicated intervention.
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