ArticleJournal of global health2026
The relationship between prolonged travel and mortality among women with complicated deliveries in rural Kenya.
Article in Journal of global health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
Abstract
Background: In many low- and middle-income settings, deliveries often take place in primary health facilities that are not equipped to address life-threatening complications. Emergency referral systems seek to rapidly transport women and newborns facing complications but inevitably introduce delays. Estimating the mortality impact of these delays is challenging due to potential selection bias. As an alternative approach, we examine the relationship between delays and adverse outcomes among a sample that is less likely to exhibit selection effects: mothers who started at a low-level facility before transfer to a hospital equipped to provide definitive care (hospital-level). Methods: We leverage demographic, obstetric, and geodata collected through the parent study Service Delivery Reform for Maternal and Newborn Health in Kakamega County, Kenya to explore the relationship between intrapartum travel and whether there was a maternal death, neonatal death, or stillbirth (adverse health outcome). We conducted a series of logistic models estimating the relationship between longer travel distances and probability of an adverse health outcome, with analyses iteratively adjusted for sociodemographic and obstetric covariates. Results: Of the 39,052 mothers with full geodata, 1,928 (4.9%) reported visiting at least one low-level facility before visiting a high-level facility. After restricting to those who experienced upward movement in facility level during delivery and adjusting for relevant covariates, we find that those in the fourth quartile of travel distances (42-436 km) had a 2.60 times higher odds of an adverse health outcome relative to those in the first quartile (2-16 km). Conclusions: Our findings show that Phase 2 delays in the form of intrapartum journeys have a pronounced association with maternal and child mortality when the total distance travelled is long. These findings align with the prior evidence that delays in receiving appropriate and timely delivery care are related to maternal and child mortality and morbidity.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.