The DHS Program

Understanding the Three Delays among Postpartum Women at Health Facilities in Nepal: Further Analysis of the Nepal Health Facility Survey 2021 (English) 

Document Type

Further Analysis

Publication Topic(s)

Maternal Health, Maternal Mortality

Country(s)

Nepal

Survey

Nepal SPA, 2021

Language

English

Recommended Citation

Riese, Sara, and Rabina Dhakal. 2023. Understanding the Three Delays among Postpartum Women in Nepal. DHS Further Analysis Report No. 144. Rockville, Maryland, USA: ICF.

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Publication Date

June 2023

Publication ID

FA144

Abstract:

This report examines the levels and determinants of the three delays model among postpartum women at health facilities in Nepal. Measures of each delay—the delay in deciding to come to a health facility (delay 1), the delay in getting to a health facility (delay 2), and the delay in seeing a health care worker after arriving at a health facility (delay 3)—were estimated from the postpartum exit interview in the 2021 Nepal Health Facility Survey (NHFS). Sociodemographic characteristics of the women and facility characteristics were included in logistic regression models to identify determinants of each delay. The most common delay was delay 2, which occurred among 47% of women. Delay 1 occurred among 11% of women, while delay 3 occurred among 6% of women. The levels of delays 1 and 2 were similar to levels in 2017, although there was a reduction in delay 3 since the 2017 NHFS. Women with basic education had higher odds of delay 1, while those with higher education had lower odds of experiencing delay 3 compared to women with no education. Women who experienced any danger signs before arriving at the health facility had higher odds of experiencing delays 1 and 2. Being accompanied to the facility by a non-husband, parent, relative, or friend was associated with lower odds of experiencing delay 2 than when being accompanied by a husband. Women who delivered at a facility with a higher level of physical resources—drugs, equipment, and commodities—had lower odds of experiencing delay 3. There were also some geographic differences, with women delivering at facilities in Lumbini Province having higher odds of delay 1, and women in Madhesh and Lumbini Province having lower odds of delay 2 compared to women delivering in facilities in Koshi Province. Characteristics associated with delays were similar for women delivering at any facility compared to women delivering only at hospitals. These findings demonstrate that nearly half of postpartum women who delivered at a health facility in Nepal experience one of the three delays, and the result can begin to shed light on which programs and policies may contribute to reductions in these delays.