ArticlePLOS global public health2025
Trends in nulliparous singleton alive births by cesarean section in India: Empirical patterns across public and private hospitals for 720 districts, 2016-2021.
Article in PLOS global public health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Unnecessary cesarean surgeries pose significant short and long-term risks, affecting fertility, future pregnancies, and child health outcomes. Timely monitoring and precise targeting are crucial to mitigate additional health and economic burdens. This study examines trends and patterns in cesarean deliveries among nulliparous singleton births across all 36 states and 720 districts in India, comparing public and private hospitals between 2016 and 2021. Using a repeated cross-sectional analysis of two waves of India's National Family Health Survey, we assess the prevalence of cesarean births and explore how the relative contribution of different geographical levels (villages/blocks, districts, states) to the total variation has evolved over time. At the national level, cesarean rates in public facilities declined by 1.2 percentage points, while private facilities saw an increase of 2.1 percentage points. Regional disparities were evident, with Telangana and Jammu & Kashmir consistently reporting the highest cesarean rates in both sectors. Variation across states was more pronounced than at other geographical levels. In private hospitals, the state-level variance partitioning coefficient increased from 69.2% in 2016 to 78.2% in 2021, whereas in public hospitals, it rose from 44.7% to 48.6% over the same period. Notably, states such as Tamil Nadu, Telangana, and Kerala had nearly all districts falling into the high-prevalence category. It is important to consider burden and variation among smaller geographical units (like districts) to monitor the burden. Increased inter-state inequalities with high prevalence among private facilities in southern states imply the absence of uniform protocols for cesarean births. This calls for urgent policy action to regulate the healthcare sector about the issue, and more awareness is required to avoid the additional health and economic burden.
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.