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Background: The majority of maternal deaths occur during delivery and the immediate postnatal period as a result of delays in seeking care, failure to reach health institutions, and receiving inappropriate health care. In developing countries, delayed access to timely healthcare contributes to high maternal mortality and morbidity. Objective: This study aimed to assess the delays during emergency obstetric care and associated factors with delays during emergency obstetric care. Method: A cross-sectional study design was conducted. We chose five hospitals at random in the South Gondar zone, Ethiopia. Face-to-face Interviews were conducted with 459 participants using a systematic sampling technique. For this analysis, bi-variable and multivariable logistic regression models were used. The Adjusted Odds Ratio was used to determine the statistical association with delays during emergency obstetric care at p-value <0.05 with a 95% confidence interval. Results: The proportion of delays during emergency obstetric care were found to be 59.7% in this study. The respondents’ mean age was 27.23 years old, with a standard error of 5.67. Pregnant mothers living in the rural areas (AOR: 4.1, 95%, CI: 2.36 to 6.25), no ANC visit (AOR: 1.8, 95% CI: 1.32 to 3.18), uneducated women (AOR: 4.6, 95% CI: 2.45 to 8.59) and referral to a higher level of care (AOR: 2.7, 95% CI: 1.60 to 4.44), were all significantly associated with delay. Conclusion: Delay during emergency obstetric care was found to be 59.7 percent. Rural residency, absence of ANC visit, uneducated mothers, and referred mothers from one level to the next level of care were factors that contributed to delays in emergency obstetric care in the study area.
An institutional-based cross-sectional study design was used to assess delays during emergency obstetric care and associated factors among all mothers who gave birth in selected hospitals between June to July 2019. This study was conducted in five selected hospitals in the South Gondar zone of Amhara Regional State, Ethiopia. Debre Tabor town serves as the zone’s capital. The town is located about 667 kilometers northwest of Addis Ababa and 103 kilometers northwest of Bahir Dar, the Amhara Regional State’s capital city. There are 2,609,823 inhabitants the administrative zone, including 1,304,911 female population [10]. One general government hospital (Debre Tabor General Hospital) and seven additional governmental hospitals (Mekane-Eyesus, Andabet, Nifas-Mewucha, Addis-Zemen, Tach Gait, Wogeda, and Event) serve the population, which is supplemented by 96 other public health centers. Agriculture is the main source of income for the majority of the population. All women who gave birth at South Gondar hospitals in 2019. All women who gave birth in randomly selected hospitals in the South Gondar zone during the data collection period. The sample size was determined using a single population proportion formula with the following assumptions: 76.3% [29] of the women who experienced delays to institutional delivery care, a 5% margin of error, 1.5 design effects, and a 10% non-response rate. We chose five hospitals at random in the South Gondar zone, Ethiopia. Interviews were conducted with 459 participants using a systematic sampling technique. Dependent variable: Delays during emergency obstetric care Independent variables: Face–to–face interviews were conducted with postpartum mothers in a private room before discharge. Women who were critically ill as a result of obstetric complications were not interviewed. Instead, their attendants were interviewed to include reports from those who have suffered as a result of delays in emergency obstetric care. In addition, the participant’s chart was reviewed to ensure that hospital records were cross-checked. Every day, the two-degree midwives supervised the five-diploma data collectors. We wrote the questionnaire in English and sent it to a linguist for revision. Then, for simplicity, we translated it to Amharic and then back to English to keep the consistency of the tool. One day of training was provided to data collectors and supervisors. The training was focused on the purpose of the study, data collection techniques, and data checks for completeness and consistency. The researchers were the only ones who could access the data, which was kept in a file cabinet. Pre-testing was performed on the questionnaire to ensure participant response, language clarity, and questionnaire appropriateness. At Wogera Hospital, data collectors interviewed 5% of the sample size to test the questionnaire. At the end of the test, ambiguous and culturally sensitive questions were amended, clarified, and adjusted before data collection began. Meaningful participants were adopted this study in increase the relevance of the research work, enhance research excellence, and help ensure patient participation is as safe, sensitive, and ethical as possible. Their advice when designing, implementing, and evaluating research invariably makes studies more effective, more credible, and often more cost-efficient as well. It can provide health benefits to patients and their families by providing the satisfaction of having influenced care, being listened to, gaining additional insight into their issues, and providing social interaction and engagement. The data were coded and entered into Epi-data version 3.1. Then, we exported it to Statistical Package of Social Science (SPSS) version 20.00 for data checking, cleaning, and analysis. We used binary logistic regression to identify statistically significant independent variables. We used bi-variable and multivariable logistic regression models for this analysis. The independent variables having a p-value of less than 0.2 were entered into multivariable logistic regression for further analysis and to adjust confounding variables. The Adjusted Odds Ratio was used to determine the statistical association with delays during emergency obstetric care at p-value <0.05 with a 95% confidence interval.
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