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Table 2 Type and reason for delays identified for maternal deaths (n = 151)

From: Factors associated with maternal mortality in Malawi: application of the three delays model

Type of delay Reason for the delay Number of women Percentage (%)a
Women who died at a healthcare facility (n = 94)
Type 3 Delay (n = 91) Long waiting time before treatment at a healthcare facility 89 94.7
  Shortage of equipment and supplies 62 66
  Wrong assessment of risk, wrong diagnosis, wrong treatment 48 51.1
  Inadequate referral system 36 40.4
  Lack of competence on EmOC among the available personnel 27 28.7
  Staff unavailable 22 23.4
  Shortage of trained staff 15 16
  Lack of treatment guidelines 12 12.7
Type 2 Delay (n = 56) Long travel time from home to a healthcare facility 49 52.1
  High cost of transportation 37 39.4
  Poor road condition or terrain, difficulty crossing rivers 17 18.1
  Visited a traditional healer first or traditional birth attendant 14 25.5
  Lack of a healthcare facility in the area 7 7.4
Type 1 Delay (n = 37) Lack of awareness of obstetric complications 20 21.3
  Low income of the family 16 17
  Visited a traditional healer 14 14.9
  Do not want to stay long at a healthcare facility 13 13.8
  Low status of a woman (not financially empowered or husband not available) 11 11.7
  Long distance to a healthcare facility 7 7.4
  Bad experience with previous health care 5 5.3
  Uneventful home delivery previously 4 4.2
  Perceived poor quality of care at a healthcare facility 3 3.1
Women who had accessed care at a healthcare facility but died at home (n = 32)
Type 3 Delay (n = 30) Long waiting time before treatment at a healthcare facility 26 81.3
  Shortage of drugs 17 53.1
  Staff unavailable 13 40.6
  Shortage of trained staff 7 21.9
  Inadequate referral system 5 15.6
Type 2 Delay (n = 11) Long travel time from home to a healthcare facility 7 21.8
  Lack of a healthcare facility in the area 5 15.6
  Cost of transportation 4 12.5
  Poor road condition or terrain, difficulty crossing rivers 3 9.3
Type 1 Delay (n = 9) Lack of awareness of obstetric complications 7 21.9
  Low income of the family 6 18.8
  Bad experience with previous health care 6 18.8
  Perceived poor quality of care at a healthcare facility 5 15.6
  Low status of a woman (not financially empowered or husband not available) 4 12.5
  Uneventful previous home delivery 3 9.4
Women who did not access care and died at home (n = 25)
Type 1 Delay Perceived poor quality of care at a healthcare facility 16 64
  Lack of awareness of obstetric complications 13 52
  Uneventful previous home delivery 9 36
  Bad experience with the previous health care 8 32
  Low status of a woman (not financially empowered or husband not available) 8 32
  Long distance to a healthcare facility 4 16
  Low financial status of the family 3 12
  1. aMore than one type of delay possible for each maternal death, presented in order of frequency