The ‘Three Delays’ in Receiving Maternal Health Services for Obstetric Complications in Rural Uttar Pradesh, India

Every year 358,000 maternal deaths take place. About 80 percent of maternal deaths result from obstetric complications and a majority of these deaths can be prevented with timely treatment. Women experiencing obstetric complication do not obtain adequate care in time due to three delays: delay in making the decision to seek care, delay in reaching an obstetric facility and delay in receiving care once the facility has been reached. According to UNFPA ‘three delay model’ is most appropriate for analysis of determinants of maternal mortality. Therefore, the objective of this paper is to examine the ‘three delays’ in receiving adequate care by women experiencing obstetric complications. Findings show that a high proportion of women experience ‘three delays’. Further study reveals that major obstacles in the decision to seek care (delay I) are low status of women, underestimation of illness severity, household responsibilities, perceived physical accessibility and QOC. Women experience delay in reaching facility (delay II) due to distance, road connectivity, unavailability of transport and cost. Availability of poor QOC in health facilities leads to further delays (delay III). Multivariate logistic regression shows that demographic, socio economic, health status, health seeking behaviour and community variables affect ‘three delays’