ArticlePLOS global public health2024
Identifying delays in healthcare seeking and provision: The Three Delays-in-Healthcare and mortality among infants and children aged 1-59 months.
Article in PLOS global public health, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers.
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Who cites it
17 citing papers in PubMed, 20 citations in OpenAlex.
- The impact of interactive text communication on neonatal mortality in Kenya: a randomized controlled trial.Nature medicine · 2025Trial
- Causes of Death Among Stillbirths and Children Aged <5 Years in Africa and South Asia - Child Health and Mortality Prevention Surveillance, Seven Countries, 2016-2024.Morbidity and mortality weekly report. Surveillance summaries (Washington, D.C. : 2002) · 2026Article
- Article
- Identifying delays impacting maternal and perinatal deaths using a facility-based death audit review system integrated with community engagement: a mixed methods study.Journal of global health · 2026Article
- Article
- Sociodemographic Drivers of Delays in Seeking Medical Care in the All of Us Cohort.Nursing reports (Pavia, Italy) · 2026Article
- Predictors of delay seeking delivery services at labor onset among pregnant women in the singida region of Tanzania: analytical cross-sectional study.Frontiers in global women's health · 2026Article
- Article
- Meeting learners where they are: case presentations in remote pediatric critical care education.Frontiers in pediatrics · 2026Article
- Presentation and management of neural tube defects in the middle belt of Ghana.Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2025Article
- Paediatric healthcare in Manhiça district through a gender lens: a retrospective analysis of 17 years of morbidity and demographic surveillance data.Journal of global health · 2025Article
- Wealth-related inequality in women healthcare-seeking behaviour for under-five children illness in Afghanistan: evidence from 2022 Afghanistan Multiple Indicator Cluster Survey.BMC health services research · 2025Article
- Use of minimally invasive tissue sampling to determine the contribution of diarrheal diseases to under-five mortality and associated co-morbidities and co-infections in children with fatal diarrheal diseases in Africa and Bangladesh.PLOS global public health · 2025Article
- Contribution of malnutrition to infant and child deaths in Sub-Saharan Africa and South Asia.BMJ global health · 2024Article
- Etiologies and comorbidities of meningitis deaths in children under 5 years in high-mortality settings: Insights from the CHAMPS Network in the post-pneumococcal vaccine era.The Journal of infection · 2024Observational
- Neurological Symptoms and Cause of Death Among Young Children in Low- and Middle-Income Countries.JAMA network open · 2024Article
- Morbidity and unplanned healthcare encounters after hospital discharge among young children in Dar es Salaam, Tanzania and Monrovia, Liberia.BMJ paediatrics open · 2024Observational
Corrections and comments
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Authors and funding
41 authors at 18 institutions in 12 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Delays in illness recognition, healthcare seeking, and in the provision of appropriate clinical care are common in resource-limited settings. Our objective was to determine the frequency of delays in the "Three Delays-in-Healthcare", and factors associated with delays, among deceased infants and children in seven countries with high childhood mortality. We conducted a retrospective, descriptive study using data from verbal autopsies and medical records for infants and children aged 1-59 months who died between December 2016 and February 2022 in six sites in sub-Saharan Africa and one in South Asia (Bangladesh) and were enrolled in Child Health and Mortality Prevention Surveillance (CHAMPS). Delays in 1) illness recognition in the home/decision to seek care, 2) transportation to healthcare facilities, and 3) the receipt of clinical care in healthcare facilities were categorized according to the "Three Delays-in-Healthcare". Comparisons in factors associated with delays were made using Chi-square testing. Information was available for 1,326 deaths among infants and under 5 children. The majority had at least one identified delay (n = 854, 64%). Waiting >72 hours after illness recognition to seek health care (n = 422, 32%) was the most common delay. Challenges in obtaining transportation occurred infrequently when seeking care (n = 51, 4%). In healthcare facilities, prescribed medications were sometimes unavailable (n = 102, 8%). Deceased children aged 12-59 months experienced more delay than infants aged 1-11 months (68% vs. 61%, P = 0.018). Delays in seeking clinical care were common among deceased infants and children. Additional study to assess the frequency of delays in seeking clinical care and its provision among children who survive is warranted.
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Registered trials
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