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. 2022 Sep 20;22(1):716.
doi: 10.1186/s12884-022-04995-3.

Caesarean section in Sudan: findings from nationwide household surveys on rates, trends, and geographic and sociodemographic variability

Manar E Abdel-Rahman  1 , Lukman Thalib  2 , Duriya A Rayis  3
Affiliations

Caesarean section in Sudan: findings from nationwide household surveys on rates, trends, and geographic and sociodemographic variability

Manar E Abdel-Rahman et al. BMC Pregnancy Childbirth. .

Abstract

Background: Medically unjustifiable caesarean section (CS) deliveries have been rising rapidly in many developed countries over the last three decades. While many developing countries show rates beyond optimal levels, few poorer countries appear to have sub-optimal obstetric care in relation to essential surgeries. The objective of this study is to document the rates of CS delivery, its time trend, and geographic and sociodemographic variability in Sudan.

Methods: We utilized a number of Multiple Indicator Cluster Surveys (MICS) conducted in 2014, 2010, and 2006 to quantify CS rates per 1000 live births. We also documented absolute changes in rates over three-time points and variation in CS rates across geographic regions and areas of residence.

Results: Over a decade, CS rates in Sudan increased steadily from 4.3% in 2006 to 6.7% in 2010 and 9.1% in 2014. During this period, CS rates varied considerably across regions showing higher rates in the Northern region (7-25%) and lower rates in Darfur (2-3%). Urban areas experienced rapidly increasing rates (6-14%), while rural areas showed negligible changes to absolute CS rates over time (5-7%). We also found geographic regions, maternal age, maternal education, receiving antenatal care, and birth order of the child were important determinants of CS in Sudan.

Conclusion: Sudan may be facing a double burden of problems associated with surgical interventions for childbirth. While the wealthier parts of Sudan are experiencing a rapid surge in CS, some poor parts of rural Sudan may not be getting the essential surgical intervention for birth when mandated. Urgent improvement to obstetric care and the development of appropriate public health interventions that focus on regional disparities are warranted.

Keywords: Area of residence; Caesarian section; Determinants; Inequalities; Regional variability; Sociodemographic; Sudan; Trend; Wealth.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Caesarean section rate and 95% confidence intervals over time, Sudan MICS 2006, 2010 and 2014 (Unweighted n = 10,776, 5646 and 5780 all livebirth, respectively)
Fig. 2
Fig. 2
Caesarean section rates by region and area of residence and by region and wealth, Sudan MICS 2014 (unweighted n = 5589 singleton births)
See this image and copyright information in PMC

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