ArticleBMC pregnancy and childbirth2022
Rural-urban disparities in caesarean deliveries in sub-Saharan Africa: a multivariate non-linear decomposition modelling of Demographic and Health Survey data.
Article in BMC pregnancy and childbirth, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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14 citing papers in PubMed.
- Prevalence and determinants of cesarean section delivery among Somali women: a multivariable analysis of a nationally representative survey.Global health action · 2026Article
- Distinct infant resistome trajectories shaped by country income and geography revealed through global metagenomics reanalysis.npj antimicrobials and resistance · 2026Article
- Exploring spatial clusters of caesarean sections across India - Insights from National Family Health Survey data.PLOS global public health · 2026Article
- Urban-rural disparities in receipt of treatment for obstetric complications in Ethiopia: A multivariate decomposition analysis.PloS one · 2026Article
- Prevalence and determinants of caesarean section delivery in Ethiopia: analysis of the 2019 EMDHS using Poisson regression with robust standard errors.BMC women's health · 2025Article
- Prevalence, urban-rural disparity and determinants of caesarean section delivery among women delivering at health facilities in 48 low- and middle-income countries: a multilevel and decomposition analysis.BMJ global health · 2025Article
- Prevalence and Determinants of Caesarean Section Deliveries in Ghana: A Population-Based Cross-sectional Study.Public health in practice (Oxford, England) · 2025Article
- Global health data precarity: Safeguarding the Demographic and Health Survey program as a global public good.Scientific data · 2025Article
- Improving Decision-to-Incision Interval (DDI) of Emergency Cesarean Sections Through Mobile-Based Obstetric Emergency System (MORES) and Midwife-Led Triage in Bong County, Liberia: A Quasi-Experimental Study.International journal of environmental research and public health · 2025Article
- Exploring the Factors Underlying the Narrowing Urban Advantage in Child Mortality in Sub-Saharan Africa: A Scoping Review.Journal of urban health : bulletin of the New York Academy of Medicine · 2025Article
- Prediction of caesarean section birth using machine learning algorithms among pregnant women in a district hospital in Ghana.BMC pregnancy and childbirth · 2025Article
- Inequality in Utilization of Maternal Healthcare Services in Low‑ and Middle‑Income Countries: A Scoping Review of the Literature.Maternal and child health journal · 2025Article
- Caesarean section and associated factors in Nigeria: assessing inequalities between rural and urban areas-insights from the Nigeria Demographic and Health Survey 2018.BMC pregnancy and childbirth · 2024Article
- Trends and determinants of early initiation of breastfeeding in Indonesia: A multivariate decomposition analysis.PloS one · 2023Article
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Abstract
introductionGlobally, the rate of caesarean deliveries increased from approximately 16.0 million in 2000 to 29.7 million in 2015. In this study, we decomposed the rural-urban disparities in caesarean deliveries in sub-Saharan Africa.
methodsData for the study were extracted from the most recent Demographic and Health Surveys of twenty-eight countries in sub-Saharan Africa. We included 160,502 women who had delivered in health facilities within the five years preceding the survey. A multivariate non-linear decomposition model was employed to decompose the rural-urban disparities in caesarean deliveries. The results were presented using coefficients and percentages.
resultsThe pooled prevalence of caesarean deliveries in the 28 countries considered in the study was 6.04% (95% CI = 5.21-6.88). Caesarean deliveries' prevalence was highest in Namibia (16.05%; 95% CI = 14.06-18.04) and lowest in Chad (1.32%; 95% CI = 0.91-1.73). For rural-urban disparities in caesarean delivery, the pooled prevalence of caesarean delivery was higher in urban areas (10.37%; 95% CI = 8.99-11.75) than rural areas (3.78%; 95% CI = 3.17-4.39) across the 28 countries. Approximately 81% of the rural-urban disparities in caesarean deliveries were attributable to the differences in child and maternal characteristics. Hence, if the child and maternal characteristics were levelled, more than half of the rural-urban inequality in caesarean deliveries would be reduced. Wealth index (39.2%), antenatal care attendance (13.4%), parity (12.8%), mother's educational level (3.5%), and health insurance subscription (3.1%) explained approximately 72% of the rural-urban disparities in caesarean deliveries.
conclusionThis study shows significant rural-urban disparities in caesarean deliveries, with the disparities being attributable to the differences in child and maternal characteristics: wealth index, parity, antenatal care attendance, mother's educational level, and health insurance subscription. Policymakers in the included countries could focus and work on improving the socioeconomic status of rural-dwelling women as well as encouraging antenatal care attendance, women's education, health insurance subscription, and family planning, particularly in rural areas.
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