title: External cephalic version in East, Central, and Southern Africa.
abstract: OBJECTIVE
  To evaluate the views of maternity care providers in East, Central, and Southern Africa on external cephalic version (ECV), and its determinants, with the aim of drawing lessons for practice.
  
  
  METHODS
  In February 2009, a cross-sectional survey using self-administered semi-structured questionnaires was conducted among delegates attending a regional conference of obstetricians and gynecologists. Descriptive statistical analysis was undertaken, and comments were analyzed for themes.
  
  
  RESULTS
  Of the 70 questionnaires issued to eligible delegates, 64 were fully completed (response rate 91%). Seventy-nine percent of respondents did not offer ECV. Approximately a third (31%) of the practitioners offered elective vaginal breech delivery. Clinicians offering ECV did so at varying gestational ages. Clinicians not offering ECV gave various reasons including concerns about the procedure's safety and lack of training and experience with it, policy restrictions, medico-legal concerns, clinician or client reluctance, and poor results with the procedure.
  
  
  CONCLUSIONS
  Overall, ECV is not widely practiced in East, Central, and Southern Africa, mainly owing to concerns related to safety and policy. Efforts aimed at reviving ECV in these regions should address these concerns. A conceptual framework of such efforts is proposed herein.
authors.affiliation: Department of Obstetrics and Gynecology, Aga Khan University Hospital, Nairobi, Kenya. mukaindo.mwaniki@aku.edu
authors.forename: Abraham M
authors.initials: AM
authors.lastname: Mukaindo
authors.forename: Sikolia Z
authors.initials: SZ
authors.lastname: Wanyonyi
authors.forename: William R
authors.initials: WR
authors.lastname: Stones
mesh_terms: D017954:Africa South of the Sahara; D001291:Attitude of Health Personnel; D003430:Cross-Sectional Studies; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D008880:Midwifery; D009774:Obstetrics; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011247:Pregnancy; D011795:Surveys and Questionnaires; D014710:Version, Fetal / Q000706:statistics & numerical data*