Recorded presentation

Ashraf Mohammed Shawat, MD, MSc, Anesthesiology, Cairo University, Sanadely St., Giza, 12211, Egypt, +20106030095, aelshawat@jsiegypt.com, Khaled Hassan Nada, MD, MSc, MA, Healthy Mother/Healthy Child, John Snow Inc., 21 Misr Helwan Agricultural Road, Floor 10, El-Maadi, Cairo, Egypt, Ossama Mohamed Wassef, MD, MSc, PhD, Public Health Department, Zagazig University, Faculty of Medicine, Benha, Egypt, and Reginald F. Gipson, MD, MPH, Healthy Mother/Healthy Child, John Snow, Inc., 21 Misr Helwan Agricultural Rd., 10th floor, Maadi, Cairo, Egypt.

Hemorrhage is the leading cause of maternal mortality in Egypt, responsible for 38% of all deaths. The purpose of this study was to identify factors related to emergency treatment of obstetric hemorrhage in Upper Egypt. Physicians were posted at four general hospitals in Upper Egypt during six months of 2003 to document patient care from the time of the initial patient complaint until the completion of treatment. Observations and patient interviews were analyzed. Barriers to getting adequate health care were varied and complex. The average time taken from the beginning of delivery until a complication was recognized by patient/relatives was six hours and 20 minutes. It took 56 minutes from the occurrence of complication until the decision to seek care was made, and three hours and 25 minutes from taking the decision until reaching the general hospital. Another barrier to seeking services was a lack of knowledge about what type of hospital to go to for treatment. Many patients (31%) went to another provider before coming to the general hospital. Only 5% came to the hospital by ambulance, often due to unawareness of how to call an ambulance or perceptions that it would take longer than by car. This presentation will feature action-oriented recommendations for addressing these barriers.

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