Abstract:
Background: Over 80 of maternal mortalities and%
complications can be prevented if women recognize
danger signs during pregnancy and promptly seek
healthcare. Despite the timely recognition of maternal
danger signs during pregnancy, delays in seeking
healthcare are still prevalent in many low-resource
settings.
Objective: To assess the place and reasons for delays
in seeking healthcare and their effect on the use of
institutional delivery care by pregnant mothers with
danger signs in Matayos subcounty, Busia, Kenya.
Methods: A mixed-methods approach employing an
ethnographic survey was adopted to assess delays
among pregnant mothers seeking healthcare in
Matayos subcounty. A total of 348 postpartum women
were selected using systematic random sampling.
Purposive sampling was employed to select
postpartum women for 16 in-depth interviews and
seven focus group discussions. Qualitative data were
analyzed thematically and presented in vignettes.
Quantitative data were analyzed using descriptive and
inferential statistics and presented in tables using
STATA version 13. Statistical significance was set at
p<0.05.
Results: The utilization rate of institutional delivery
care was 68 . One in four, 25 (86) respondents% %
experienced danger signs, of which more than half,
51.2 (44), reported delays. Travel to the hospital%
(type 3 delay) was the most common delay reported by
65.3 , followed by delayed decision-making at home%
(type 2 delay), delayed recognition at home (type 1
delay), and delays in hospitals (type 4 delay) at 30.7 ,%
1.7 , and 2.3 of all respondents, respectively.% %
Delayed decision to initiate travel (30.7 ) and%
distance to healthcare (30.7 ), cost of travel (18.2 ),% %
and mode of travel (13.2 ) were the reasons for%
delays in seeking healthcare.
Conclusion: Delayed decision-making rather than
recognition of danger signs was associated with
delays in healthcare. A four-delay model clearly
distinguished between recognition and making the
decision to initiate travel and should be adopted in
low-resource settings.
