Table 1 Distribution of causes and their proportion of maternal deaths

Delay as a risk factor for maternal death

These factors affect the interval between the onset of an obstetric complication in a pregnant woman and her outcome. These factors delay the parturient’s decision to seek healthcare in time (first delay), delay her arrival at a health facility in time (second delay), and delay the timely provision of adequate healthcare (third delay) [19]

Delay I (R1)

This delay pertains to the decision by the woman, family, or community to go to the hospital for obstetric care when she begins to feel the signs of danger before delivery [20]. It is associated with the sociocultural context, socioeconomic status of the parturient, knowledge of the signs of danger in pregnancy and/or perception of the severity of the disease during pregnancy, previous cost of care, and previous experience with the health system [21]

Delay II (R2)

This delay pertains to the arrival of the parturient at the health facility for obstetric care. It refers to the problems of accessibility—the distance between the woman’s home and the health facility, poor road infrastructure, cost of transportation, and distribution of health facilities in the health zone where she resides—that prevent her from timely arriving at the hospital [22]

Delay III (R3),

This delay pertains to obstetric care of the woman by the healthcare personnel in a health facility. This factor is linked to the service offered by the health facility to the parturient and refers to the incompetence of the healthcare personnel and the insufficiency or absence of materials, medical equipment, supplies (medicines), and qualified personnel who could provide a suitable environment and other essential factors [23]