ArticleBMC pregnancy and childbirth2020
A ten year analysis of maternal deaths in a tertiary hospital using the three delays model.
Article in BMC pregnancy and childbirth, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 34 papers.
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34 citing papers in PubMed.
- Determinants of Delays in Receiving Labor and Delivery Care at Health Facilities: An Analysis of the 2021 Nepal Health Facility Survey.Maternal and child health journal · 2026Article
- Understanding the role of parental decision-making and quality of clinical care in under-5 mortality in Western Kenya: an application of the Three Delays model.BMC health services research · 2026Article
- Prevalence of Maternal Third Delays in Emergency Obstetric Care and Determinant Factors Among Women Giving Birth in Government Hospitals in East Gojjam Zone, Northwest Ethiopia: A Cross-Sectional Study.Health science reports · 2026Article
- The Six Delays Model: expanding the three delays model with evidence from Madagascar for maternal referrals in LMICs.BMJ global health · 2026Review
- Variability in the Causes and Delay Factors Contributing to Maternal Mortality: Evidence From Maternal Death Surveillance Reports of 22 African Countries.BJOG : an international journal of obstetrics and gynaecology · 2026Article
- Assessing metrics for evaluating the maternal continuum of care in Ethiopia: A scoping review.PLOS global public health · 2026Article
- Maternal Mortality in Pakistan: Demographic, Temporal, and Contextual Insights From the Three Delays Model.Cureus · 2025Article
- Maternal death surveillance in Addis Ababa, Ethiopia, 2017-2021: Causes and contributing factors.Global epidemiology · 2025Article
- Geographic inequalities, and social-demographic determinants of reproductive, maternal and child health at sub-national levels in Kenya.BMC public health · 2025Article
- MOMs Chat & Care Study: Rationale and design of a pragmatic randomized clinical trial to prevent severe maternal morbidity among Black birthing people.Contemporary clinical trials · 2025Article
- Maternal Mortality: Causes, trends and delays in care at Tertiary care hospital, Pakistan.Pakistan journal of medical sciences · 2025Article
- Article
- Maternal delay for institutional delivery and associated factors among postnatal mothers at Southeastern Ethiopia: a cross sectional study.BMC pregnancy and childbirth · 2024Article
- Delay in reaching health facilities for emergency obstetric care and associated factors among postpartum mothers at Bale zones, Ethiopia. A cross-sectional study.PLOS global public health · 2024Article
- Effect of simulation-based training workshop on obstetric emergency team collaboration and communication: a mixed study.Frontiers in medicine · 2024Article
- Challenges of health workers in primary health facilities in implementing obstetric emergency referrals to save women from death in Indonesia: A qualitative study.Belitung nursing journal · 2024Article
- Developing the BornFyne prenatal management system version 2.0: a mixed method community participatory approach to digital health for reproductive maternal health.Oxford open digital health · 2024Article
- Men's knowledge, attitudes, and associated factors toward obstetric danger signs: A community-based cross-sectional study in Debre Tabor North West, Ethiopia.Journal of family medicine and primary care · 2023Article
- Article
- Conceptualising factors impacting nutrition services coverage of treatment for acute malnutrition in children: an application of thePublic health nutrition · 2023Article
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19 authors.
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Abstract
backgroundReducing maternal mortality ratios (MMRs) remain an important public health issue in Egypt. The three delays model distinguished three phases of delay to be associated with maternal mortality: 1) first phase delay is delay in deciding to seek care; 2) second phase delay is delay in reaching health facilities; and 3) third phase delay is delay in receiving care in health facilities. Increased health services' coverage is thought to be associated with a paradigm shift from first and second phase delays to third phase delay as main factor contributing to MMR. This study aims to examine the contribution of the three delays in relation to maternal deaths.
methodsDuring a 10 year period (2008-2017) 207 maternal deaths were identified in a tertiary hospital in Minia governorate, Egypt. Data were obtained through reviewing medical records and verbal autopsy for each case. Then data analysis was done in the context of the three delays model.
resultsFrom 2008 to 2017 MMR in this hospital was 186/100.000 live births. Most frequent causes of maternal mortality were postpartum hemorrhage, hypertensive disorders of pregnancy and sepsis. Third phase delay occurred in 184 deaths (88.9%), second phase delay was observed in 104 deaths (50%), always together with other phases of delay. First phase delay alone was observed in 13 deaths (6.3%) and in 82 deaths (40%) with other phases of delay. One fifth of the women had experienced all three phases of delay together. Major causes of third phase delay were delayed referral from district hospitals, non-availability of skilled staff, lack of blood transfusion facilities and shortage of drugs.
conclusionsThere is a paradigm shift from first and second phases of delay to the third phase of delay as a major contributor to maternal mortality. Reduction of maternal mortality can be achieved through improving logistics, infrastructure and health care providers' training.
trial registrationThis study is a retrospective study registered locally and approved by the ethical committee of the Department of Obstetrics and Gynaecology, Minia University Hospital on 1/4/2016 (Registration number: MUEOB0002).
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