Perinatal audit using the 3-delays model in western Tanzania

Int J Gynaecol Obstet. 2009 Jul;106(1):85-8. doi: 10.1016/j.ijgo.2009.04.008. Epub 2009 May 12.


Objective: To audit intrapartum fetal and early neonatal deaths of infants weighing >or=2000 g in a regional hospital in western Tanzania.

Methods: The 3-delays methodology was applied to a cohort of perinatal deaths from July 2002 to July 2004.

Results: The overall perinatal mortality rate in the hospital was 38 per 1000 live births, and in just over half of these cases the birth weight was >or=2000 g. The leading clinicopathologic causes of death were birth asphyxia (19.0%), prolonged or obstructed labor (18.5%), antepartum hemorrhage (11.5%), and uterine rupture (9.0%). First delays occurred in 19.0% of the cases, second delays occurred in 21.5%, and third delays occurred in 72.5%.

Conclusion: For women who delivered in this hospital, most of the substandard care occurred after admission to the health facility. The improvement of institutional health care may have a significant impact on the decision to attend health institutions and, thereby, reduce first delays.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Birth Weight
  • Female
  • Fetal Death / epidemiology
  • Fetal Death / etiology
  • Hospital Mortality
  • Humans
  • Infant Mortality*
  • Infant, Newborn
  • Medical Audit / methods*
  • Perinatal Mortality*
  • Pregnancy
  • Pregnancy Complications / epidemiology
  • Quality of Health Care*
  • Tanzania / epidemiology
  • Time Factors