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Determinants of delays in travelling to an emergency obstetric care facility in Herat, Afghanistan: an analysis of cross-sectional survey data and spatial modelling

Overview of attention for article published in BMC Pregnancy and Childbirth, February 2015
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About this Attention Score

  • Above-average Attention Score compared to outputs of the same age (60th percentile)

Mentioned by

twitter
3 tweeters

Citations

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33 Dimensions

Readers on

mendeley
157 Mendeley
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Title
Determinants of delays in travelling to an emergency obstetric care facility in Herat, Afghanistan: an analysis of cross-sectional survey data and spatial modelling
Published in
BMC Pregnancy and Childbirth, February 2015
DOI 10.1186/s12884-015-0435-1
Pubmed ID
Authors

Atsumi Hirose, Matthias Borchert, Jonathan Cox, Ahmad Shah Alkozai, Veronique Filippi

Abstract

BackgroundWomen¿s delays in reaching emergency obstetric care (EmOC) facilities contribute to high maternal and perinatal mortality and morbidity in low-income countries, yet few studies have quantified travel times to EmOC and examined delays systematically. We defined a delay as the difference between a woman¿s travel time to EmOC and the optimal travel time under the best case scenario. The objectives were to model travel times to EmOC and identify factors explaining delays. i.e., the difference between empirical and modelled travel timesMethodsA cost-distance approach in a raster-based geographic information system (GIS) was used for modelling travel times. Empirical data were obtained during a cross-sectional survey among women admitted in a life-threatening condition to the maternity ward of Herat Regional Hospital in Afghanistan from 2007 to 2008. Multivariable linear regression was used to identify the determinants of the log of delay.ResultsAmongst 402 women, 82 (20%) had no delay. The median modelled travel time, reported travel time, and delay were 1.0 hour [Q1-Q3: 0.6, 2.2], 3.6 hours [Q1-Q3: 1.0, 12.0], and 2.0 hours [Q1-Q3: 0.1, 9.2], respectively. The adjusted ratio (AR) of a delay of the ¿one-referral¿ group to the ¿self-referral¿ group was 4.9 [95% confidence interval (CI): 3.8-6.3]. Difficulties obtaining transportation explained some delay [AR 2.1 compared to ¿no difficulty¿; 95% CI: 1.5-3.1]. A husband¿s very large social network (>¿=¿5 people) doubled a delay [95% CI: 1.1-3.7] compared to a moderate (3-4 people) network. Women with severe infections had a delay 2.6 times longer than those with postpartum haemorrhage (PPH) [95% CI: 1.4-4.9].ConclusionsDelays were mostly explained by the number of health facilities visited. A husband¿s large social network contributed to a delay. A complication with dramatic symptoms (e.g. PPH) shortened a delay while complications with less-alarming symptoms (e.g. severe infection) prolonged it. In-depth investigations are needed to clarify whether time is spent appropriately at lower-level facilities. Community members need to be sensitised to the signs and symptoms of obstetric complications and the urgency associated with them. Health-enhancing behaviours such as birth plans should be promoted in communities.

Twitter Demographics

The data shown below were collected from the profiles of 3 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 157 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Colombia 1 <1%
Kenya 1 <1%
Canada 1 <1%
Belgium 1 <1%
Spain 1 <1%
Unknown 152 97%

Demographic breakdown

Readers by professional status Count As %
Student > Master 41 26%
Researcher 16 10%
Student > Bachelor 15 10%
Student > Ph. D. Student 15 10%
Student > Postgraduate 14 9%
Other 26 17%
Unknown 30 19%
Readers by discipline Count As %
Medicine and Dentistry 52 33%
Nursing and Health Professions 27 17%
Social Sciences 18 11%
Business, Management and Accounting 5 3%
Computer Science 3 2%
Other 14 9%
Unknown 38 24%

Attention Score in Context

This research output has an Altmetric Attention Score of 3. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 20 February 2015.
All research outputs
#1,944,991
of 4,785,233 outputs
Outputs from BMC Pregnancy and Childbirth
#637
of 1,193 outputs
Outputs of similar age
#59,349
of 152,868 outputs
Outputs of similar age from BMC Pregnancy and Childbirth
#29
of 40 outputs
Altmetric has tracked 4,785,233 research outputs across all sources so far. This one has received more attention than most of these and is in the 59th percentile.
So far Altmetric has tracked 1,193 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 5.1. This one is in the 46th percentile – i.e., 46% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 152,868 tracked outputs that were published within six weeks on either side of this one in any source. This one has gotten more attention than average, scoring higher than 60% of its contemporaries.
We're also able to compare this research output to 40 others from the same source and published within six weeks on either side of this one. This one is in the 27th percentile – i.e., 27% of its contemporaries scored the same or lower than it.