There are important factors preventing timely care-seeking and effective system response for obstetric emergencies and delivery. Delay due to unfamiliarity with warning signs, especially among family members, discouragement from revealing pregnancy early in gestation, gender inequalities, complex and untimely decision-making processes, fear of mistreatment by health-care providers, lack of recognition by frontline staff and delay in escalation within the health system, lack of transport and financial constraints.

Led by Professor Jane Sandall, DR Veronique Fillipi and Dr Helena Boene, we will draw on our LMIC-based research to address health system contexts, barriers and facilitators in each of the different countries and in rural and urban settings. This will include investigation of the contribution of micro-financing, and health systems strengthening within the context of WHO standards to improve quality of care.