Introduction: Ensuring access to quality caesarean section (CS) care is a key millenium development strategy and the next sustainable development goal to reduce maternal and infant mortality. The WHO recommends that the caesarean section rate should not exceed 10-15%. The objective of our analysis is to document the variability of caesarean section rates in Sub-Saharan Africa. Material and method: we carried out a review of 26 studies for the simple proportions of events using the R metafor package (Viechtbauer, 2010). The studies were selected in the following way: the type of study, target population and keys words (such as intra operative complications, caesarean section utilization, maternal mortality or perinatal mortality or morbidity and caesarean section, Africa south of the Sahara or sub Saharan Africa). We performed a random-effects meta-analysis, and heterogeneity was assessed using the I 2 value. Result: the overall proportion of caesarean sections is 19% (14%-24%) for 26 selected studies. The I 2 index is equal to 99.92%, suggesting a very high level of heterogeneity. Journal impact factors accounted for this heterogeneity. Conclusion: the best CS rate is the one that gives the best outcome with regard to foetal and maternal benefi t. This rate may vary as obstetric problems differ from one country to another. Studies published in higher impact journals tend to report a lower proportion of CS than articles published in lower impact journals.

Introduction:Ensuring access to quality caesarean sections (CS) is a challenge for the next millennium and a sustainable development goal to reduce maternal and infant mortality. A CS involves risks and complications and should therefore be performed in an approved way and not used excessively. The WHO recommends that the CS rate should not exceed 10-15%. Approximately 99% of maternal deaths occur in developing countries where efforts to reduce maternal deaths are still low. This review of the literature aims to provide a summary of CS practices in sub-Saharan Africa and the consequences in terms of morbidity and mortality. Material and Method:The data was collected following the selection criteria on the NCBI's PubMed.Result: Across the four main themes selected for this summary, the frequency of CS varies from 2 to 51%. Indications for caesarean CS are mainly dystocia, foetal distress, scarred uterus, breech presentation, antenatal haemorrhage and hypertensive disorders. Maternal risks related to CS are surgical site infections, obstetric fi stulae, anaesthetic complications, pulmonary embolism, postpartum haemorrhage, haemostatic hysterectomy and maternal death, and the perinatal risks related to CS are respiratory distress, prematurity and perinatal death. Conclusion:In the current working conditions, the risks incurred by the mother and the foetus during a CS are signifi cantly greater than during a vaginal delivery. CS is not yet a factor in reducing maternal and perinatal morbidity and mortality in Sub-Saharan Africa. To reduce maternal and perinatal morbidity and mortality, working conditions at referral centre level, transfer conditions, and improve the training of health staff should be improved. Citation:Dikete M, Coppieters Y, Trigaux P, Englert Y, Simon P, et al. (2019) An analysis of the practices of caesarean section in sub-Saharan Africa: A summary of the literature. Arch Community Med Public Health 5(2): 077-086. DOI: http://dx.References were selected based on the following criteria: the type of study on CS, the target population and the data analysis using the following search terms on PubMed (intraoperative complications, caesarean section, maternal mortality and morbidity, perinatal mortality and morbidity, Africa South of the Sahara) for the period from 2011 to 2016 (the period during which we started missions to support the training of gynaecologists and obstetricians in the east of the Democratic Republic of the Congo). The following inclusion criteria were applied: articles focusing essentially on the CS, the indications for a CS, and maternal and perinatal complications associated with CS in sub-Saharan Africa. The studies selected were retrospective, prospective, clinical trials and ecological studies. Clinical cases were excluded from this review. The target population is the population of sub-Saharan Africa: the population studied was composed of women who had a CS delivery and their new-borns infants. The registrations of the participants involved in the various studies were examined...