Kenya has recorded a 20 per cent Caesarean section rate, raising concerns over the growing reliance on surgical deliveries and widening inequalities in access to maternal healthcare.
The 2025-26 Kenya Mini Demographic and Health Survey shows that Caesarean births have increased five-fold, from four per cent of all live births in 2003 to 17 per cent in 2022, before reaching 20 per cent in 2025-26.
The latest figure comes amid concerns raised by the World Health Organization (WHO) over unnecessary Caesarean deliveries, which can expose mothers and newborns to avoidable surgical risks when performed without medical justification.
WHO has previously noted that Caesarean section rates above 10 per cent are not associated with further reductions in maternal and newborn mortality.
The survey reveals significant disparities in Caesarean deliveries based on household wealth and geographical location, with women from wealthier households considerably more likely to undergo the procedure.
In urban areas, 29 per cent of live births were delivered through Caesarean section, compared to 14 per cent in rural areas.
The economic divide is even wider, with 41 per cent of births among women in the highest wealth quintile delivered through Caesarean section, compared to just nine per cent among women in the lowest wealth quintile.
The findings point to a two-sided challenge in maternal healthcare, where wealthier women may be exposed to unnecessary surgical interventions while poorer women could face difficulties accessing emergency Caesarean deliveries when medically required.
At the county level, Kiambu recorded the highest Caesarean section rate at 39 per cent, followed by Nyeri at 37 per cent, Murang’a at 36 per cent, Nairobi at 31 per cent and Makueni at 30 per cent.
Mandera recorded the lowest rate at two per cent, followed by Wajir at five per cent, Trans Nzoia at six per cent, Kilifi at seven per cent and Garissa and Nakuru at eight per cent each.
Tana River and Kwale each recorded nine per cent.
Overall, 21 of Kenya’s 47 counties recorded Caesarean section rates above 15 per cent.
When performed for appropriate medical indications, says the report, caesarean sections can substantially reduce maternal and neonatal morbidity and mortality.
The survey also established that the likelihood of undergoing a Caesarean section decreases with increasing birth order.
First-time mothers recorded a rate of 24 per cent, compared to seven per cent among women who had given birth six times or more.
Antenatal care attendance was also associated with higher rates of surgical deliveries.
Women who attended four or more antenatal care visits recorded a rate of 22 per cent, compared to two per cent among those who had no antenatal care visits.
The report recommends the use of the Robson Classification System to monitor and evaluate Caesarean section rates.
“The WHO further recommends that caesarean sections be performed only when medically necessary, and supports the use of the Robson Classification System for monitoring and evaluating CSRs (WHO 2017c),” read the report.
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