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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 30 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 1 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   Healthcare provider unavailable
Perceived poor quality of care at a the healthcare facility   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   Lack of treatment guidelines e.g. Pre-eclampsia, PPH, manual removal of placenta etc