Abstract:
Background: Many countries have exceeded WHO recommended a population-level of C
section rate of 10–15%, leading to both health and economic implications to mothers around the
world. There is Knowledge and geographical gap about cesarean section (C/S) in Hargeisa,
Somaliland. Hence, this will fill the knowledge by finding the prevalence and associated factors
of cesarean section among mothers who gave birth in Hargeisa, Somaliland.
Objective: The study aims to assess the prevalence of cesarean section delivery and its
associated factors among mothers who gave birth at Hargeisa hospitals, Hargeisa, Somaliland,
2025.
Methods: An institution-based cross-sectional study design was employed among systematic
randomly selected 580 mothers who gave birth at Hargeisa hospitals, Hargeisa, Somaliland from
01-30 May, 2025. A kobo collect incorporated with structured questionnaire is used to collect
data. After data exploration, it was entered in STATA V.17. Descriptive statistics was employed
to estimate frequency and prevalence. Bivariable and multivariable logistic analyses is carried
out to identify independent associated factors of cesarean section. Model fitness and Multi
collinearity has been done.
Result: The prevalence of cesarean delivery among mothers was 35.0% (95% CI: 31.2%
38.9%). Factors associated with cesarean delivery included being housewife (AOR = 0.87, 95%
CI: 0.21–0.87), husband’s with primary education (AOR = 0.47; 95% CI: 0.26–0.86), had history
of previous cesarean section (AOR = 9.51; 95% CI: 6.07–14.89), multiple pregnancy (AOR =
2.00; 95% CI: 1.42–2.85), and being multi-parity (AOR = 0.53; 95% CI: 0.32–0.89).
Conclusion: Cesarean section delivery was high among mothers in Hargeisa. Key associated
factors included maternal occupation, husband’s education, previous cesarean section multiple
pregnancy, and parity. Targeted prenatal wellness programs, standardized cesarean counseling,
and specialized VBAC clinics should be implemented, alongside enhanced monitoring for
multiple pregnancies and structured support for first-time mothers are recommended to reduce
unnecessary cesarean sections and improve maternal and neonatal outcomes.
