TITLE:
Caesarean Section Rates and Associated Maternal and Neonatal Outcomes in Rural Health Zones of Beni and Lubero, North Kivu, Democratic Republic of the Congo
AUTHORS:
Justine Vuma Musubao, Fratier Kambale Kyuma, Kashinde Trésor Mosomo, Claude Ngona Mandro, Kasereka Claude Masumbuko, Jean-Jeannot Sihalikyolo Juakali
KEYWORDS:
Caesarean Section, Maternal Outcomes, Neonatal Outcomes, Rural Health, North Kivu
JOURNAL NAME:
Journal of Biosciences and Medicines,
Vol.13 No.11,
November
13,
2025
ABSTRACT: Background: Caesarean section (CS) is a life-saving obstetric intervention that reduces maternal and neonatal mortality when medically indicated. However, the increasing frequency of CS in resource-limited settings raises concerns about clinical justification, quality of care, and maternal-fetal outcomes. This study aimed to determine the frequency of caesarean sections and assess associated maternal and neonatal outcomes in eight rural health zones of the Beni and Lubero territories, North Kivu Province, Democratic Republic of Congo (DRC). Methods: A descriptive, multicenter study was conducted in eight rural health zones: Biena, Kalunguta, Kyondo, Lubero, Manduredjipa, Masereka, Musienene, and Vuhovi, from 2017 to 2023. Exhaustive sampling was applied, and retrospective data were obtained from delivery registers in health facilities offering a comprehensive package of activities. Data were analyzed using Epi Info 7.2 software, and descriptive statistics summarized the findings. Results: Among 171,000 deliveries recorded, 70,960 were caesarean sections, corresponding to an overall rate of 41%. CS frequency varied from 38% in Kyondo to 49% in Kalunguta. Neonatal mortality among CS deliveries ranged from 1% in Musienene to 4% in Lubero, Biena, and Kalunguta. Maternal mortality was higher among women delivered by CS compared with those who delivered vaginally. The leading indications for CS were previous uterine scar (29.07%), cephalopelvic disproportion (15.09%), and fetal distress (9.06%). Conclusions: The CS rate in the rural health zones of Beni and Lubero is considerably higher than the WHO-recommended threshold of 15%. Further investigation is required to identify the factors underlying this high rate and to strengthen obstetric care quality and equity in rural DRC.