section (C-section) considered as a public health problem, is one of the most
common surgeries in the world. The procedure is often performed without medical
need, thus putting women and their neonates at risk of short- and long-term
health problems 1. Recent reports have suggested that the rates of C-section continue to
skyrocket, particularly in high- and middle-income countries 12. The international healthcare community considered
the ideal rate for cesarean sections to
be between 10% and 15% 123.
Malawi government follows the United Nations (UN) indicators, which recommend
that a minimum of 5% and a maximum of 15% of all births should be delivered by
C-section 4. However, the World Health Organization (WHO)
underscores the importance of focusing on the needs of the patient and discourages
the practice of aiming for target rates 2. C-section may be necessary when vaginal delivery poses
a risk to the mother or neonate particularly due to fetal distress, prolonged
labor, or because the baby is presenting in an abnormal position 13. Unfortunately, the procedure can lead to significant
problems, disability or death, predominantly in settings that lack the
facilities to conduct safe surgeries or treat potential complications 23.
studies in many settings have reported that the causes of an increase in C-sections are multifactorial and poorly
understood 5. Notably, changes in maternal characteristics (i.e.
higher educational education, rise in maternal age, prior cesarean section, prolonged
labor, and increasing maternal Body Mass Index) 56, infant characteristics (i.e. baby weight – suspected
low infant birthweight or macrosomia, length of the baby) 67 and professional practice styles, increasing
malpractice pressure – private hospital status, as well as economic,
organizational, social and cultural factors have all been implicated in an increase in C-sections 5.
is one of the most important risk factors for postpartum maternal infection which
account for approximately 10% of pregnancy-related mortality and it carries a risk of infection 5 to 20 times that of vaginal
delivery 8910. In Malawi, since 1992, the rates of C-sections have been
on the rise. The 2015–16 Malawi Demographic and Health
Survey (MDHS) reported that only 3% of births occurred with C-section in
1992-2000 compared with 5% in 2010 and 6% in 2015-16 11. For better results on C-section, it is necessary to
contextualize the sociocultural determinants. Thus, the present study aimed to investigate
the associated factors of C-sections from
2004 to 2015 using the population-based