Main themes | The emerged sub-themes | Factors contributing to the delay in seeking EmOC services | Studies |
---|---|---|---|
Delay I | Socio-demographic and economic factors | Young age | |
Uneducated women | |||
Attending only primary/secondary education | |||
Unemployment | |||
Rural residence | |||
Poverty and low income | |||
Unmarried | [53] | ||
Language issues | [49] | ||
Lack of information about service | |||
Being occupied with harvest and other duties | [46] | ||
Community perception about obstetric complications | Socio-cultural | ||
Belief in alternative method | |||
Negative perception of the service | |||
Social stigma | [48] | ||
Lack of trust in HCW | |||
Expecting improvement over time | [63] | ||
Fear of procedure like surgery and blood donation | |||
Desire for home delivery | |||
Lack of women’s autonomy and poor male involvement | Women not involved in decision-making | ||
Poor male involvement | |||
Knowledge of obstetric danger signs | Lack of awareness about obstetric complications | ||
Inability to identify complications | |||
Obstetric history and health service use | Inadequate ANC use | ||
Higher parity and gravidity | |||
Previous uncomplicated pregnancy | |||
Poor birth preparedness and complication readiness | |||
Unwanted pregnancy | [53] | ||
Previous bad experiences at facility and dissatisfaction | |||
Delay II | Poor transport infrastructure | Lack of vehicles | |
Shortage of ambulances | |||
Poor road infrastructure and geography | |||
Distance from health facilities | Long distance from facility | ||
Lack of health facility in rural area | |||
Poor referral communication | |||
Sought care first from dispensary or health centre | |||
Lack of finance for transportation | Lack of money for transportation | ||
Delay III | Lack of EmOC services and supplies | Unavailability of EmOC services | |
Lack of drugs, medical supplies, and equipment | |||
Shortage of rooms and utilities | |||
Lack of blood | |||
Sub-standard care at facility | |||
Healthcare providers’ training and attitude | Shortage of healthcare providers | ||
Lack of competence among providers | |||
Misdiagnosis and inappropriate treatment | |||
Shortage of training | |||
Long waiting time | |||
Provider’s poor attitude | |||
Lack of privacy | |||
Poor management system | Poor supportive supervision | ||
Poor staff motivation | |||
Staff absenteeism | |||
Lack of coordination and feedback | |||
Heavy workload | |||
High staff turnover | |||
Poor communication system | |||
Patient overcrowding | |||
Delayed referral | |||
Lack of guidelines and protocol | |||
Unaccountability | |||
High treatment cost | |||
Simplicity of obtaining drugs | [60] |