Caesarean section rates in the Arab region: a cross-national study.

This study had a dual purpose of estimating population- and hospital-based caesarean section rates in 18 Arab countries and examining the association between these rates and important indicators of socioeconomic development. Data on caesarean section were based on the most recent population-based surveys undertaken in each country. Descriptive statistics and bivariate correlation coefficients were used for the analysis. Specifically, Spearman's rank correlation coefficients were used to analyze the associations between caesarean section rates and important population parameters. Results revealed that four Arab countries had population-based caesarean rates below 5%, while only three countries had rates above 15%. The remaining 11 countries had caesarean rates ranging between 5-15%. Higher hospital-based rates were reported for all countries. Differences in caesarean section rates between private and public hospitals were also noted. Highly significant associations were observed between population caesarean rates and female literacy, percentage urban, infant mortality rate, and the proportion of physicians per 100 000 people. The "caesarean section epidemic" observed in countries of Latin America is not yet evident in the 18 Arab countries examined. Rather, emphasis should be on improving access to appropriate obstetrical interventions in case of complications in a number of countries where rates were well below 5%.