ArticleThe Pan African medical journal2014
Barriers to emergency obstetric care services: accounts of survivors of life threatening obstetric complications in Malindi District, Kenya.
Article in The Pan African medical journal, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 36 papers, 4 of them syntheses that pooled it.
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Who cites it
36 citing papers in PubMed, 4 syntheses or guidelines pooled it, 52 citations in OpenAlex.
- Stated Preference Research in Reproductive and Maternal Healthcare Services in Sub-Saharan Africa: A Systematic Review.The patient · 2022Pooled it
- Barriers to access and utilization of emergency obstetric care at health facilities in sub-Saharan Africa: a systematic review of literature.Systematic reviews · 2018Pooled it
- Identifying barriers for out of hospital emergency care in low and low-middle income countries: a systematic review.BMC health services research · 2018Pooled it
- Access barriers to obstetric care at health facilities in sub-Saharan Africa-a systematic review.Systematic reviews · 2017Pooled it
- Multistakeholder perspectives on geographical accessibility to emergency obstetric care in Benin City, Nigeria.African journal of emergency medicine : Revue africaine de la medecine d'urgence · 2026Article
- Severe maternal outcomes in 36 West African hospitals from Benin, Burkina Faso and Niger.BMC pregnancy and childbirth · 2025Article
- "Attitude is the fifth delay": perspectives of obstetric near-miss survivors and health care professionals on continuity and coordination of maternal care.BMC health services research · 2025Article
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- Global maternal mortality projections by urban/rural location and education level: a simulation-based analysis.EClinicalMedicine · 2024Article
- Strengthening caesarean birth: Sub-Saharan Africa health system evaluation: Scoping review.African journal of primary health care & family medicine · 2024Article
- "How I wish we could manage such things": A qualitative assessment of barriers to postpartum hemorrhage management and referral in Kenya.PLOS global public health · 2024Article
- A mixed methods study on continuity and care coordination based on the obstetric near miss approach.Health SA = SA Gesondheid · 2024Article
- Strengthening Kampala's Urban Referral System for Maternal and Newborn Care Through Establishment of an Emergency Call and Dispatch Center.Global health, science and practice · 2023Article
- Self-reported continuity and coordination of antenatal care and its association with obstetric near miss in Uasin Gishu county, Kenya.African journal of primary health care & family medicine · 2023Article
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- Mobile health technology to improve maternal health awareness in tribal populations: mobile for mothers.Journal of the American Medical Informatics Association : JAMIA · 2021Article
- Perceived Barriers in Accessing Health Care and the Risk of Pregnancy Complications in Indonesia.International journal of women's health · 2021Article
- Utility of the three-delays model and its potential for supporting a solution-based approach to accessing intrapartum care in low- and middle-income countries. A qualitative evidence synthesis.Global health action · 2020Review
- Perspectives of health workers on the referral of women with obstetric complications: a qualitative study in rural Sierra Leone.BMJ open · 2020Article
Corrections and comments
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Authors and funding
6 authors at 4 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionPregnancy-related mortality and morbidity in most low and middle income countries can be reduced through early recognition of complications, prompt access to care and appropriate medical interventions following obstetric emergencies. We used the three delays framework to explore barriers to emergency obstetric care (EmOC) services by women who experienced life threatening obstetric complications in Malindi District, Kenya.
methodsA facility-based qualitative study was conducted between November and December 2010. In-depth interviews were conducted with 30 women who experienced obstetric "near miss" at the only public hospital with capacity to provide comprehensive EmOC services in the district.
resultsFindings indicate that pregnant women experienced delays in making decision to seek care and in reaching an appropriate care facility. The "first" delay was due to lack of birth preparedness, including failure to identify a health facility for delivery services regardless of antenatal care and to seek care promptly despite recognition of danger signs. The "second" delay was influenced by long distance and inconvenient transport to hospital. These two delays resulted in some women arriving at the hospital too late to save the life of the unborn baby.
conclusionDelays in making the decision to seek care when obstetric complications occur, combined with delays in reaching the hospital, contribute to ineffective treatment upon arrival at the hospital. Interventions to reduce maternal mortality and morbidity must adequately consider the pre-hospital challenges faced by pregnant women in order to influence decision making towards addressing the three delays.
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