Reducing Maternal Mortality in Uganda: Applying the “Three Delays” Framework

PURPOSE: This article examines maternal mortality in Uganda through the “Three Delays” framework. This framework asserts that maternal mortality in developing countries results from three delays to accessing appropriate health care: (a) the delay in making a timely decision to seek medical assistance, (b) the delay in reaching a health facility, and (c) the delay in provision of adequate care at a health facility.

STUDY DESIGN: This study provides a review and synthesis of literature published about maternal mortality, the “Three Delays” concept, Uganda, and sub-Saharan Africa between 1995 and 2010.

MAJOR FINDINGS: The “Three Delays” framework has relevance in the Ugandan context. This framework allows for an integrated and critical analysis of the interactions between cultural factors that contribute to the first delay and inadequate emergency obstetrical care related to the third delay.

MAJOR CONCLUSION: In order to reduce maternal mortality in Uganda, governments and institutions must become responsive to the cultural and health needs of women and their families. Initiatives that increase educational and financial status of women, antenatal care, and rates of institutional care may reduce maternal mortality in the long term. Improvements to emergency obstetrical services are likely to have the most significant impact in the short term.