Prevalence of Cesarean Section Delivery and Its Associated Factors among Mothers Who Gave Birth at Hargeisa Hospitals, Hargeisa, Somaliland, 2025 an Institution Based Cross Sectional Study

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.