Risk factors of cesarean delivery among women in Somalia: evidence from the countrywide demographic and health survey

Cesarean section (CS) rates are rising globally; however, disparities exist, especially in low- and middle-income countries (LMICs) like Somalia, where healthcare access is limited. Therefore, this study aims to identify the risk factors associated with CS delivery in Somalia, with the goal of informing targeted interventions to improve maternal and child health This study utilized data extracted from the 2020 Somalia Demographic and Health Survey (SDHS-2020), which is a countrywide, cross-sectional study. The study comprised a total of 1208 women. The association between CS delivery and various socioeconomic and demographic factors was explored by logistic regression. The CS rate in Somalia was found to be 9.35%. Mothers aged 23–28 years (AOR: 1.20, 95% CI: 0.49, 2.92) and 29–34 years (AOR: 1.29, 95% CI: 0.29, 5.77) were approximately 1.2 times more likely to have a cesarean delivery than mothers aged 11–16 years. According to the level of education, a mother with higher education (AOR: 0.48, 95% CI: 0.21, 1.11) had fewer odds of having a cesarean delivery than illiterate mothers. Mothers from the rich families have 0.39 times less odds (AOR: 0.39, 95% CI: 0.12,1.23) of undergoing CS deliveries than mothers from the poor families (0.12,1.23). Higher parity (3 + ) is associated with increased odds of CS delivery, though there is some debate in the literature about the effect of parity on CS delivery. Regional variations existed, with women in certain regions less likely to undergo CS compared to others. Regional disparities in CS utilization in Somalia suggest the need for targeted interventions to improve maternal healthcare access and address regional inequalities, thereby ensuring appropriate and equitable CS utilization and ultimately improving maternal and child health outcomes. Mothers’ education should be increased to increase awareness of the negative health consequences of CS deliveries and to lessen the burden of CS deliveries.