Asif Mahmood Mattoo, Saadia Hameed, Asif Maqsood Butt.
Assessment of `Three Delays Model`: an Experience at Public Sector MCH Hospital.
Pak J Med Res Jan ;58(2):83-7.

Background: Maternal Mortality is a strong indicator of human development that points towards health of the women, accessibility and the quality of the health services. Nearly two third of the maternal deaths all over the world are due to direct causes e.g hemorrhage, sepsis and eclampsia. Objective: To assess the role of three delays in maternal mortality at a public sector hospital. Study type, settings and duration: A descriptive cross sectional study was carried out at Holy Family Hospital, Rawalpindi, from October to December 2016. Methodology: Data concerning age, socio-economic, demographic, parity, booking, referral center and cause of the three delays was collected on a structured questionnaire from 200 respondents by interviewing them, their relatives and history files. Data was analyzed in SPSS version 20 and the results were presented in tabular form as frequencies and percentages. Results: It was found that first delay was the most frequent one and faced by 70% respondents after the onset of labor pains. Total of 47% told that late decision of the husband to seek care was the reason for delay whereas 22% reported that midwives were responsible for this delay. For the second delay, the study reflected that almost 52% of respondents reached the facility within an hour while the remaining took longer because of distance, and volume of traffic. The third delay was faced by 35% because of heavy patient flow to the obstetrics emergency department where 83% were attended by doctors within 30 minutes after reaching the facility. Conclusion: This study findings concluded that delay in decision making to seek out care and delay in reaching a suitable health facility in time were mainly the contributors to maternal morbidity and mortality. Lack of knowledge and poor socio-economic factors were also highlighted as the major reasons of these delays.

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