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{"title"=>"Piecing Together the Maternal Death Puzzle through Narratives: The Three Delays Model Revisited", "type"=>"journal", "authors"=>[{"first_name"=>"Viva", "last_name"=>"Combs Thorsen", "scopus_author_id"=>"55532079200"}, {"first_name"=>"Johanne", "last_name"=>"Sundby", "scopus_author_id"=>"55337383300"}, {"first_name"=>"Address", "last_name"=>"Malata", "scopus_author_id"=>"20436083700"}], "year"=>2012, "source"=>"PLoS ONE", "identifiers"=>{"issn"=>"19326203", "isbn"=>"1932-6203 (Electronic) 1932-6203 (Linking)", "pmid"=>"23284882", "scopus"=>"2-s2.0-84871280617", "doi"=>"10.1371/journal.pone.0052090", "sgr"=>"84871280617", "pui"=>"366299730"}, "id"=>"ca74fabe-d6ae-3fcf-889d-41d9204b841b", "abstract"=>"BACKGROUND: In Malawi maternal mortality continues to be a major public health challenge. Going beyond the numbers to form a more complete view of why women die is critical to improving access to and quality of emergency obstetric care. The objective of the current study was to identify the socio-cultural and facility-based factors that contributed to maternal deaths in the district of Lilongwe, Malawi.\\n\\nMETHODS: Retrospectively, 32 maternal death cases that occurred between January 1, 2011 and June 30, 2011 were reviewed independently by two gynecologists/obstetricians. Interviews were conducted with healthcare staff, family members, neighbors, and traditional birth attendants. Guided by the grounded theory approach, interview transcripts were analyzed manually and continuously. Emerging, recurring themes were identified and excerpts from the transcripts were categorized according to the Three Delays Model (3Ds).\\n\\nRESULTS: Sixteen deaths were due to direct obstetric complications, sepsis and hemorrhage being most common. Sixteen deaths were due to indirect causes with the main cause being anemia, followed by HIV and heart disease. Lack of recognizing signs, symptoms, and severity of the situation; using traditional Birth Attendant services; low female literacy level; delayed access to transport; hardship of long distance and physical terrain; delayed prompt quality emergency obstetric care; and delayed care while at the hospital due to patient refusal or concealment were observed. According to the 3Ds, the most common delay observed was in receiving treatment upon reaching the facility due to referral delays, missed diagnoses, lack of blood, lack of drugs, or inadequate care, and severe mismanagement.", "link"=>"http://www.mendeley.com/research/piecing-together-maternal-death-puzzle-through-narratives-three-delays-model-revisited", "reader_count"=>121, "reader_count_by_academic_status"=>{"Unspecified"=>4, "Professor > Associate Professor"=>2, "Librarian"=>1, "Researcher"=>17, "Student > Doctoral Student"=>11, "Student > Ph. D. Student"=>26, "Student > Postgraduate"=>7, "Student > Master"=>31, "Other"=>6, "Student > Bachelor"=>9, "Lecturer"=>5, "Lecturer > Senior Lecturer"=>1, "Professor"=>1}, "reader_count_by_user_role"=>{"Unspecified"=>4, "Professor > Associate Professor"=>2, "Librarian"=>1, "Researcher"=>17, "Student > Doctoral Student"=>11, "Student > Ph. D. Student"=>26, "Student > Postgraduate"=>7, "Student > Master"=>31, "Other"=>6, "Student > Bachelor"=>9, "Lecturer"=>5, "Lecturer > Senior Lecturer"=>1, "Professor"=>1}, "reader_count_by_subject_area"=>{"Engineering"=>1, "Unspecified"=>6, "Environmental Science"=>1, "Nursing and Health Professions"=>19, "Biochemistry, Genetics and Molecular Biology"=>2, "Medicine and Dentistry"=>61, "Agricultural and Biological Sciences"=>1, "Philosophy"=>1, "Psychology"=>1, "Social Sciences"=>27, "Economics, Econometrics and Finance"=>1}, "reader_count_by_subdiscipline"=>{"Engineering"=>{"Engineering"=>1}, "Medicine and Dentistry"=>{"Medicine and Dentistry"=>61}, "Social Sciences"=>{"Social Sciences"=>27}, "Psychology"=>{"Psychology"=>1}, "Economics, Econometrics and Finance"=>{"Economics, Econometrics and Finance"=>1}, "Agricultural and Biological Sciences"=>{"Agricultural and Biological Sciences"=>1}, "Nursing and Health Professions"=>{"Nursing and Health Professions"=>19}, "Biochemistry, Genetics and Molecular Biology"=>{"Biochemistry, Genetics and Molecular Biology"=>2}, "Unspecified"=>{"Unspecified"=>6}, "Environmental Science"=>{"Environmental Science"=>1}, "Philosophy"=>{"Philosophy"=>1}}, "reader_count_by_country"=>{"Turkey"=>1, "Norway"=>1, "Italy"=>1, "Zimbabwe"=>1, "Ethiopia"=>1, "India"=>1}, "group_count"=>6}

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Figshare

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• {"files"=>["https://ndownloader.figshare.com/files/522221"], "description"=>"*<p>In labour, prior to completion of the second stage.</p><p>The 32 maternal deaths were reviewed and categorized according to their respective antepartum, intrapartum, and postpartum state upon death.</p>", "links"=>[], "tags"=>["public health and epidemiology", "obstetrics", "women's health"], "article_id"=>192719, "categories"=>["Cell Biology", "Mathematics", "Biotechnology"], "users"=>["Viva Combs Thorsen", "Johanne Sundby", "Address Malata"], "doi"=>["https://dx.doi.org/10.1371/journal.pone.0052090.t002"], "stats"=>{"downloads"=>0, "page_views"=>0, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Stage_of_Pregnancy_upon_death_/192719", "title"=>"Stage of Pregnancy upon death.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2013-02-19 18:25:29"}
• {"files"=>["https://ndownloader.figshare.com/files/522245"], "description"=>"<p>Based on chart notes and two independent reviews, the cause of death for each maternal death was determined, confirmed, tallied, and grouped according to whether the cause contributed directly or indirectly to the death.</p>", "links"=>[], "tags"=>["indirect", "causes", "frequencies", "maternal"], "article_id"=>192743, "categories"=>["Cell Biology", "Mathematics", "Biotechnology"], "users"=>["Viva Combs Thorsen", "Johanne Sundby", "Address Malata"], "doi"=>["https://dx.doi.org/10.1371/journal.pone.0052090.t003"], "stats"=>{"downloads"=>0, "page_views"=>0, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Direct_amp_Indirect_Causes_and_Frequencies_of_Maternal_Deaths_/192743", "title"=>"Direct & Indirect Causes and Frequencies of Maternal Deaths.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2013-02-19 18:25:38"}

PMC Usage Stats | Further Information

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Relative Metric

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F1000Prime