DELAYS DURING EMERGENCY OBSTETRIC CARE AND ASSOCIATED FACTORS AMONG MOTHERS WHO GAVE BIRTH IN PUBLIC HOSPITALS OF BALE AND EAST BALE ZONES, OROMIA REGION, SOUTH EAST ETHIOPIA

Abstract

Introduction: Delays in timely seeking care, failure to reach health institutions, and receiving ineffective health care cause maternal mortality in developing countries. The three-delay model was used to identify contributing factors to maternal death. There was limited data on the delays in emergency obstetric care services in the area. Therefore, the aim of this study was to assess the magnitude of delays during emergency obstetric care and associated factors among postnatal mothers in the Bale and east Bale zones. Methods: A facility-based cross-sectional study was conducted among 407 postnatal women from April 6 to May 6, 2022. A systematic sampling technique was used to select study participants .The data were collected electronically using an Open Data Kit and exported to SPSS window version 25 for cleaning and analysis. Both bivariable and multivariable analysis was done by using binary logistic regression model to identify factors associated with delays in emergency obstetric care services. Statistical significance was declared at P-value < 0.05. Results: In this study, the magnitude of the first, second, and third delays were 29.2% (95% CI: 24.9, 33.9), 38.1% (95%CI: 33.3, 43), and 34.6% (95% CI: 30, 39.5), respectively. No antenatal care follow up (AOR=2.86; 95% CI: 1.57, 5.21), and decision-making (AOR= 0.36; 95% CI: 0.17, 0.75) were significantly associated with the first delay. The following factors showed significant association with second maternal delay: Average monthly income (AOR=1.87; 95% CI: 1.12, 3.14), distance (AOR= 4.35; 95% CI: 2.65, 7.14), referral from other health facilities (AOR = 1.77; 95% CI: 1.01, 3.11), and delay one (AOR=2.9; 95% CI: 1.7, 4.93). Average monthly income (AOR= 1.79; 95% CI: 1.03, 3.10), delay one (AOR = 2.07; 95% CI: 1.21, 3.53), and multiple referrals (AOR= 0.10; 95% CI: 0.06, 0.18) were factors identified as third delay. Conclusion and recommendations: This study showed that the magnitude of first, second, and third maternal delays in the utilization of emergency obstetric care services in the study area were high. The most common delay was related to difficulty in reaching the healthcare facility. Promoting road accessibility, transport mechanisms and health education on antenatal care shall be emphasized.