The Three Delays

Tackling the three delays to maternal health

In the past 25 years, the world has almost halved maternal deaths. However, every year, some 300,000 women still die during pregnancy and childbirth globally, and almost 3 million babies do not survive their first four weeks of life.

A vast majority of these largely preventable deaths take place in developing and crisis-affected countries. In Uganda, about 5,145 women die every year due to pregnancy and child birth-related complications, according to a recent UN report on maternal mortality in Uganda.

If deployed in the right numbers, transport facilities could avert a good number of these deaths since the high maternal mortality rates is often reflective of access to health care services.

14 women dying daily

The above figures mean that at least 14 women will die due to maternal complication related to pregnancy or delivery. These include but are not limited to severe bleeding, infections, and obstructed labor. All of these causes of death are largely preventable.

Traditionally, Ugandan women seek to handle birth on their own as it is a time when they can use their own power and make their own decisions which can also be a factor in such a high maternal mortality rate.

Although the problem is general in Uganda, it even gets worse in the rural areas where women face multiple barriers to accessing lifesaving maternal health care.

The barriers fall into the Three Delays Model:

Delay 1: Delay to seek help

pregnant woman 21

Most expectant mothers delay to take the decision to seek help. (Source: Daily Monitor)

Women (or their families) often wait too long to leave for a health facility. Some women are completely bared by cultural beliefs from seeking professional help.

Delay 2: Delay to reach health centers


On such a bad road, the Village Ambulance can be unattached and the expectant mother pushed/pulled in the trailer.

The next delay emerges when the mother can’t find transport to the sparsely available rural health facilities. The delay may also emerge when a mother requires being moved to another health care center for advanced healthcare services.

Delay 3: Delay to receive medical care

Epectant mothers attend antenatal clinic at Aromo health centre on Monday. Drug shortage has hit the facility and, officials say only female and male condoms are available. PHOTO BY BILL OKETCH

Expectant mothers wait to be attended to by health workers in Northern Uganda. (Source: Daily Monitor)

After going through the above two, a mother then encounters challenges once they reach a facility finding appropriately trained health care providers that have the necessary supplies and medications to serve them.

How we are mitigating The Three Delays

Although our dedicated area of focus lies in The Second Delay: The delay in reaching adequate and appropriate treatment, we have a strong belief that focusing on this phase improves factors in the other two phases of delay.

We believe that improving transport using our affordable and reliable Village Ambulance will serve as a motivator and incentive for women to seek care (First Delay) and the improvements in the two phases will serve as push factors to improve accessibility to care (Third Delay).


Our Village Ambulance provides quick and affordable transportation solutions for expectant mothers

It also deals with the delay in receiving referral services since our Village Ambulance is swift, affordable and designed for hard to reach areas. This makes our approach of proving transport as the primary solution an integral one, as it overrides in the two other delays.

What is more is that the Three Delays Model addresses the barriers to accessing lifesaving treatment by outlining where each barrier may occur. Central to this model is the practice of encouraging women to seek care as soon as possible, in order to ensure survival.

At Pulse, we have a carefully thought program and equally competent staff to implement the model.

Please contact us:

Tirupati Business Park
Kyebando, Kampala, Uganda
Ware house # 70
+256 776 353935, +256 716 353935