Maternal death and delays in accessing emergency obstetric care in Mozambique

Leonardo Antonio Chavane,Marc Aerts,Osvaldo Loquiha,Marleen Temmerman,Patricia Bailey,Martinho Dgedge

doi:10.1186/s12884-018-1699-z

Abstract

BackgroundDespite declining trends maternal mortality remains an important public health issue in Mozambique. The delays to reach an appropriate health facility and receive care faced by woman with pregnancy related complications play an important role in the occurrence of these deaths. This study aims to examine the contribution of the delays in relation to the causes of maternal death in facilities in Mozambique.MethodsSecondary analysis was performed on data from a national assessment on maternal and neonatal health that included in-depth maternal death reviews, using patient files and facility records with the most comprehensive information available. Statistical models were used to assess the association between delay to reach the health facility that provides emergency obstetric care (delay type II) and delay in receiving appropriate care once reaching the health facility providing emergency obstetric care (delay type III) and the cause of maternal death within the health facility.ResultsData were available for 712 of 2,198 maternal deaths. Delay type II was observed in 40.4% of maternal deaths and delay type III in 14.2%.and 13.9% had both delays. Women who died of a direct obstetric complication were more likely to have experienced a delay type III than women who died due to indirect causes. Women who experienced delay type II were less likely to have also delay type III and vice versa.ConclusionsThe delays in reaching and receiving appropriate facility-based care for women facing pregnancy related complications in Mozambique contribute significantly to maternal mortality. Securing referral linkages and health facility readiness for rapid and correct patient management are needed to reduce the impact of these delays within the health system.

Highlights

Despite declining trends maternal mortality remains an important public health issue in Mozambique
The second delay refers to the delay to reach the facility that provides emergency obstetric care (EmONC) and, the third delay refers to the delay that occurs in receiving care after arrival at the health facility [3]
With this paper we aim to examine the relationship between the cause of maternal death and delays II and III

Summary

Introduction

Despite declining trends maternal mortality remains an important public health issue in Mozambique. The delays to reach an appropriate health facility and receive care faced by woman with pregnancy related complications play an important role in the occurrence of these deaths. Maternal death and delays in accessing emergency obstetric care in Mozambique Delays in access to quality care have been identified as one of the important determinants of preventable maternal death [1, 2]. The model has been helpful identifying barriers and potential points of intervention along the continuum from home to hospital for more than 20 years [4,5,6]. According to this framework 3 delays in access to quality emergency care are defined. The second delay (delay II) refers to the delay to reach the facility that provides emergency obstetric care (EmONC) and, the third delay (delay III) refers to the delay that occurs in receiving care after arrival at the health facility [3]

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Conclusion