Three ‘Delays’ as a Framework for Critical Analysis of Maternal Near Miss and Maternal Mortality

Abstract

ABSTRACT Objective The aim of the study was to assess the magnitude and causes of three delays and their possible implications for safe motherhood. Methods The cross-sectional prospective study was carried out over a period of 1 year from January to December 2010. All patients who fulfill the WHO criteria for maternal near miss and all cases of maternal death during this period were included in the study. The various factors responsible for the delays in accessing obstetrics care facilities at all the three levels were analyzed. Results During 1 year period there were 10,553 emergency admissions in labor room and there were 4538 deliveries, out of these 123 patients who fulfilled the WHO criteria for near miss were included in the study. 83% of patients (102) reported first delay in seeking care and the most common reason for delay was inability to judge the graveness of situation. After initial care there was a delay in reaching a facility with comprehensive obstetric care in 62% of cases (76 patients) and this delay was of around 6 to 8 hours. Once the patients reached Jinnah Hospital there was a delay in about 15 (12%) patients. There were 13 maternal deaths during this period of 1 year and there was a delay both at seeking initial care and referral by the initial care providers. Conclusion Delay in deciding to seek care (1st delay) was the major factors responsible for high maternal mortality and morbidity. So the role of community actors such as mothers in law, husbands, local healers and pharmacies and increased access to properly trained birth attendants need to be addressed if delays in reaching health facilities are to be shortened. How to cite this article Yunus S, Kauser S, Ali S. Three ‘Delays’ as a Framework for Critical Analysis of Maternal Near Miss and Maternal Mortality. J South Asian Feder Obst Gynae 2013;5(2):57-59.