Assessment of Factors Contributing to Third Delay In Obstetric Care In Lady Willington Hospital, Lahore

Abstract

Objective: Study was designed to assess the underlying factors causing third delay in getting obstetric care after reaching tertiary care hospital. Study Design: This was a descriptive study conducted through cross sectional approach, employing non-probability convenience sampling technique. Place and Duration of Study: The study was carried out from 08^th July to 15^th July 2008 in Lady Willingdon Hospital, Lahore, a tertiary care obstetrics institution affiliated with King Edward Medical University, Lahore. Subjects and Methods: A study sample of 50 obstetric cases (pregnant women) was selected: half (25) were interviewed from 08.00 am to 08.00 pm during first four days and next half (25) from 08.00 pm to 08.00 am during the next four days to observe the situation / condition round the clock. As such, every pregnant woman coming to the emergency with any presenting complaint requiring immediate intervention during study period was followed till the outcome of pregnancy. A precise, pre-tested questionnaire was used for the purpose of data collection including demographic information. The record of subjects was consulted for any useful information. Physical verification for all drugs and equipments was also carried out. Data was cleaned, analyzed manually and partially on computer for applying test of significance. Data of timings was entered on SPSS computer programme. Students “t"test was employed for calculating the significance of time difference during day & night. P value <0.05 was considered significant. Results: Out of study sample of 50, 28 (56%) subjects presented with some complications, while 22 (44%) with normal pregnancy. 15 (54%) subjects from amongst those who presented with some complication had low educational status / were illiterate –whereas- 16 (74%) subjects from amongst those who presented with normal pregnancy had high education. It was due to the fact that educated couples utilize health care services, which eventually have positive impact on the pregnancy outcome. There was delay in transferring the subjects to operation theatre. Moreover, the subjects presenting with some complications were not evaluated urgently. Conclusion: The socio-demographic factors like educational status of subjects / both spouses have been found impacting the third delay. There was no appreciable delay in providing services with insignificant difference of day & night. Third delay is avoidable, if functional healthcare delivery system is in place and through rational solutions, improvement can be brought in the quality of care. The results of study underline a need to vigorously implement well planned supervision and monitoring system to provide training for quality service delivery. Key Words: Comprehensive Emergency Obstetric Care, Tertiary Care Hospital, Third Delay