Adressing the first delay in maternal and newborn health : A case study on the Mayuge District in Uganda

Abstract: Global maternal and newborn mortality have made much progress in recent years. Forexample, newborn deaths have almost halved since the 1990s, and the global maternalmortality rate (MMR) has been reduced by nearly 38 percent during the same period.Maternal and newborn deaths are still unacceptably high, and an estimated 2.7 millionnewborns die worldwide each year, most of them in low-income countries (Lawn et al.,2016). The Mayuge District in rural southeastern Uganda is a district experiencing significantmaternal and newborn health difficulties. According to Willey et al. (2018), 438 expectantmothers die from childbirth-related complications per 100,000 live births, and 23 newbornsdie per 1000 live births in the Mayuge District. The 3-delays model is used in researchconcerning maternal and newborn health worldwide and works to simplify and categorize thecauses of poor maternal and newborn health (Bergström et al., 2009). The delays aredescribed as follows; (1) delay in seeking care; (2) delay in reaching a healthcare facility; and(3) delay in receiving appropriate care.This study focuses on the first delay, which is the delay in seeking healthcare, and examinesif stigma and social identity affect health-seeking behavior in the district. Other identifiedfactors affecting health-seeking behavior will be presented during the study and compiledalongside possible recommended interventions to combat the issues. According to the resultspresented in this study, stigmatization, culture, tradition, and misinformation are evidentdrivers for the delay in seeking healthcare in the Mayuge district in Uganda. This studyfurther reveals that inherited social identity could be identified as traditional aspects andaffect people's health-seeking behavior. It is shown that the district suffers from poormaternal and newborn health caused by all of the three delays presented in this study.However, the results of this study show that the first delay is one of the least researched andthat the local government gives little to no attention to the delay in seeking healthcare in thedistrict.