'The clock keeps ticking' - the role of a community-based intervention in reducing delays in seeking emergency obstetric care in rural Bangladesh: a quasi-experimental study

Objective: To explore the role of a community-based intervention in reducing delays in accessing emergency obstetric care (EmOC) in rural Bangladesh, and the factors associated with delayed decision making, reaching the health facility and receiving treatment. Study design: Quasi-experimental study...

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Main Authors:	Banu, Morsheda, Akter, Mahmuda, Begum, Khadiza, Choudhury, Rashedul, Nasreen , Hashima E
Format:	Article
Language:	English
Published:	Elsevier Ltd 2014
Subjects:	RA Public aspects of medicine
Online Access:	http://irep.iium.edu.my/39690/ http://irep.iium.edu.my/39690/ http://irep.iium.edu.my/39690/1/Clocks_keep_ticking_final_version_PUHE2025.pdf

id	iium-39690
recordtype	eprints
spelling	iium-396902018-06-20T01:38:58Z http://irep.iium.edu.my/39690/ 'The clock keeps ticking' - the role of a community-based intervention in reducing delays in seeking emergency obstetric care in rural Bangladesh: a quasi-experimental study Banu, Morsheda Akter, Mahmuda Begum, Khadiza Choudhury, Rashedul Nasreen , Hashima E RA Public aspects of medicine Objective: To explore the role of a community-based intervention in reducing delays in accessing emergency obstetric care (EmOC) in rural Bangladesh, and the factors associated with delayed decision making, reaching the health facility and receiving treatment. Study design: Quasi-experimental study. Methods: Multistage random sampling was used to select 540 villages, from which 1200 women who reported obstetric complications in March–April 2010 were interviewed. Results: The median time taken to make the decisions to access health care was significantly lower in the intervention areas compared with the control areas (80 vs 90 min). In addition, the median time taken to reach the health facility was significantly lower in intervention areas compared with the control areas (110 vs 135 min). However, no difference was found in the median time taken to receive treatment. Multiple linear regressions demonstrated that community intervention significantly reduced decision making and time taken to reach the health facility when accessing EmOC in rural Bangladesh. However, for women experiencing haemorrhage, the delays were longer in the intervention areas. Protective factors against delayed decision making included access to television, previous medical exposure, knowledge, life-threatening complications during childbirth and use of primary health facility. Financial constraints and traditional perceptions were associated with delayed decision making. Complications during labour, use of a motorized vehicle and use of a primary health facility were associated with faster access to EmOC and poverty, distance, transportation difficulties and decision making by male guardian were associated with slower access to EmOC. Conclusions: The intervention appeared to reduce the time taken to make the decision to access health care and time taken to reach the health facility when accessing EmOC. This study provides support for a focus on emergency preparedness for timely referral from the community. Elsevier Ltd 2014-04-08 Article PeerReviewed application/pdf en http://irep.iium.edu.my/39690/1/Clocks_keep_ticking_final_version_PUHE2025.pdf Banu, Morsheda and Akter, Mahmuda and Begum, Khadiza and Choudhury, Rashedul and Nasreen , Hashima E (2014) 'The clock keeps ticking' - the role of a community-based intervention in reducing delays in seeking emergency obstetric care in rural Bangladesh: a quasi-experimental study. Public Health, 2014 , 128. pp. 332-340. ISSN 0033-3506 7047/ 39690
repository_type	Digital Repository
institution_category	Local University
institution	International Islamic University Malaysia
building	IIUM Repository
collection	Online Access
language	English
topic	RA Public aspects of medicine
spellingShingle	RA Public aspects of medicine Banu, Morsheda Akter, Mahmuda Begum, Khadiza Choudhury, Rashedul Nasreen , Hashima E 'The clock keeps ticking' - the role of a community-based intervention in reducing delays in seeking emergency obstetric care in rural Bangladesh: a quasi-experimental study
description	Objective: To explore the role of a community-based intervention in reducing delays in accessing emergency obstetric care (EmOC) in rural Bangladesh, and the factors associated with delayed decision making, reaching the health facility and receiving treatment. Study design: Quasi-experimental study. Methods: Multistage random sampling was used to select 540 villages, from which 1200 women who reported obstetric complications in March–April 2010 were interviewed. Results: The median time taken to make the decisions to access health care was significantly lower in the intervention areas compared with the control areas (80 vs 90 min). In addition, the median time taken to reach the health facility was significantly lower in intervention areas compared with the control areas (110 vs 135 min). However, no difference was found in the median time taken to receive treatment. Multiple linear regressions demonstrated that community intervention significantly reduced decision making and time taken to reach the health facility when accessing EmOC in rural Bangladesh. However, for women experiencing haemorrhage, the delays were longer in the intervention areas. Protective factors against delayed decision making included access to television, previous medical exposure, knowledge, life-threatening complications during childbirth and use of primary health facility. Financial constraints and traditional perceptions were associated with delayed decision making. Complications during labour, use of a motorized vehicle and use of a primary health facility were associated with faster access to EmOC and poverty, distance, transportation difficulties and decision making by male guardian were associated with slower access to EmOC. Conclusions: The intervention appeared to reduce the time taken to make the decision to access health care and time taken to reach the health facility when accessing EmOC. This study provides support for a focus on emergency preparedness for timely referral from the community.
format	Article
author	Banu, Morsheda Akter, Mahmuda Begum, Khadiza Choudhury, Rashedul Nasreen , Hashima E
author_facet	Banu, Morsheda Akter, Mahmuda Begum, Khadiza Choudhury, Rashedul Nasreen , Hashima E
author_sort	Banu, Morsheda
title	'The clock keeps ticking' - the role of a community-based intervention in reducing delays in seeking emergency obstetric care in rural Bangladesh: a quasi-experimental study
title_short	'The clock keeps ticking' - the role of a community-based intervention in reducing delays in seeking emergency obstetric care in rural Bangladesh: a quasi-experimental study
title_full	'The clock keeps ticking' - the role of a community-based intervention in reducing delays in seeking emergency obstetric care in rural Bangladesh: a quasi-experimental study
title_fullStr	'The clock keeps ticking' - the role of a community-based intervention in reducing delays in seeking emergency obstetric care in rural Bangladesh: a quasi-experimental study
title_full_unstemmed	'The clock keeps ticking' - the role of a community-based intervention in reducing delays in seeking emergency obstetric care in rural Bangladesh: a quasi-experimental study
title_sort	'the clock keeps ticking' - the role of a community-based intervention in reducing delays in seeking emergency obstetric care in rural bangladesh: a quasi-experimental study
publisher	Elsevier Ltd
publishDate	2014
url	http://irep.iium.edu.my/39690/ http://irep.iium.edu.my/39690/ http://irep.iium.edu.my/39690/1/Clocks_keep_ticking_final_version_PUHE2025.pdf
first_indexed	2023-09-18T20:57:02Z
last_indexed	2023-09-18T20:57:02Z
_version_	1777410373161320448

'The clock keeps ticking' - the role of a community-based intervention in reducing delays in seeking emergency obstetric care in rural Bangladesh: a quasi-experimental study

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