Table 1 Framework for analysis used to identify type of delay for maternal deaths
From: Factors associated with maternal mortality in Malawi: application of the three delays model
Delay 1 – Decision to seek care | Delay 2 – Reaching care | Delay 3 – Receiving care |
|---|---|---|
Low status (woman not financially independent or husband not available) | No healthcare facility in the area. (takes more than one hour to reach healthcare facility) | Long waiting time before treatment was received (more than 30Â min from the time of arrival to time of being assessed or receiving treatment) |
Lack of awareness of obstetric complications | Long travel time from home to a healthcare facility (more than an hour) | Shortage of equipment and supplies |
Nearest healthcare facility is more than 1Â km away | Cost of transportation | Wrong assessment of risk, wrong diagnosis, wrong treatment |
Uneventful previous home delivery | Poor road condition or terrain | Shortage of healthcare providers |
The family has insufficient money | Visited a traditional healer or traditional birth attendant first | Lack of competence or skills among the available healthcare providers |
Poor experience of previous health care received at a healthcare facility | Â | Healthcare provider unavailable |
Perceived poor quality of care at a the healthcare facility | Â | Inadequate referral system, (ambulances not available, no fuel, breakdown and use of public transport) |
Avoiding admission and long stay (more than two days) at a healthcare facility | Â | Lack of treatment guidelines e.g. Pre-eclampsia, PPH, manual removal of placenta etc |