Delays in maternal-neonatal care: qualitative assessment of neonatal deaths in reference health facilities of the Peruvian Ministry of Health

Abstract

 

INTRODUCTION:

Accelerating the decrease of child mortality involves facing the neonatal mortality effectively by the implementation of opportune and appropriate interventions.

OBJECTIVES:

To identify potential delays in the maternal-neonatal care through a qualitative assessment of neonatal deaths between July and December, 2011 in Huanuco and Ucayali, Peru.

MATERIALS AND METHODS:

Qualitative study that included 22 in-depth interviews with mothers of newborns who died during the study period, using a semi-structured guide based on the standard questionnaire of verbal autopsy recommended by World Health Organization. Additional questions were included to indentify delays in the attention following the three-delays model: a) in the decision making for seeking medical care; b) in seeking care due to limited access to health services; and c) in receiving medical care at the health facility.

RESULTS:

Most of delays were in the health services, and were associated with failures in key maternal-neonatal practices: labor assessment, delivery care, diagnosis of the newborn, and management of healthy and critically ill newborns.

CONCLUSION:

The study has identified delays and failures in the maternal-neonatal care in the same study health facilities, which require corrective actions in order to have a positive impact on neonatal mortality.