Demographic and Health Surveys: caesarean section rates in sub-Saharan Africa

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Abstract
We analysed Demographic and Health Surveys performed at two different times in eight sub-Saharan African countries—Burkina Faso (1992 and 1999), Cameroon (1991 and 1998), Ghana (1993 and 1998), Kenya (1993 and 1998), Madagascar (1992 and 1997), Niger (1992 and 1998), Tanzania (1992 and 1996), and Zambia (1992 and 1996).4 We calculated caesarean section rates for singleton live births that occurred during the three years before the interviews, weighted for the complex sample designs. We calculated urban and rural rates according to the residence of the mothers. We used a logistic regression of the pooled data from the eight countries to calculate the crude odds ratio of having a caesarean section during 1991–3 (reference group) and 1996-9. We calculated confidence intervals after taking the complex design into account. In a next step, we added mother's age (<20, 20-34, ≥35 years), parity (1, 2-4, ≥5), and residence (urban, rural) to the logistic regression. We also calculated the proportion of singleton live births delivered in health facilities and included place of delivery in the logistic regression.