Praying for Divine Intervention: The Reality of “The Three Delays” in Northern Nigeria
Abstract
This paper describes how pregnant women in three northern Nigerian communities responded to maternal complications that occurred outside of a hospital setting. The sample consisted of 322 women who had recently delivered, of which 15% had at least one complication. Thirty-seven percent of women described antepartum or postpartum haemorrhage. Over 60% of women went to a health care facility, but 35% first tried herbal remedies and another 20% simply waited for their husband to return. The median interval between recognizing the problem and deciding to seek help was two hours. It took approximately one to two hours to reach the hospital and upon arrival, most respondents got care in one to two hours. Rural communities clearly have their own hierarchy of appropriate actions in the face of a household emergency which need to be understood in order to develop creative intervention strategies to reduce unnecessary risks to the life of a mother (Afr. J. Reprod. Health 2010; 14[3]: 113-119).
Résumé
Prière pour l’intervention divine: La réalité « des trois délais » au nord du Nigéria. Cette étude fait une description de la manière dont les femmes dans les trois communautés du nord du Nigéria ont réagi aux complications maternelles qui se produisent en dehors du milieu hospitalier. L’échantillon comprenait 322 femmes qui venaient récemment d’accoucher, dont au moins 15% avaient une complication. Trente-cinq pourcent des femmes ont décrit l’hémorragie de l’ante-partum ou de post-partum. Plus de 60% des femmes ont fréquenté un établissement de santé, mais trente-cinq pourcent ont essayé les remèdes à base de plantes et un autre 20% n’ont fait qu’attendre que leurs maris rentrent. L’intervalle moyen entre la reconnaissance du problème et la décision de rechercher l’aide était deux heures. On mettait presque deux heures pour arriver à l’hôpital et une fois là-bas, la plupart des interrogées ont reçu des soins au cours d’une heure ou deux. Les communautés rurales ont clairement leur propre hiérarchie d’actions appropriées face à une urgence familiale qu’on doit comprendre afin de développer des stratégies de l’intervention créatrice pour réduire les risques inutiles de la vie d’une mère (Afr. J. Reprod. Health 2010; 14[3]: 113-119).
Key words: Maternal mortality, obstetric emergency, three delays, obstetric complications, actions taken.
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