Applicability of the Three Delays Model in the context of maternal mortality: integrative review

ABSTRACT The objective of this review is to summarize evidence available in the scientific literature from the applicability of the Three Delays Model in the context of maternal mortality in terms of causal factors and interventional measures. It is an integrative literature review, carried out with no time frame, in seven databases, with the descriptors Maternal Mortality, Pregnancy Complications, Maternal Death and the keyword Three Delays Model. 15 studies were selected for analysis. The first delay stood out as a determinant of maternal deaths, with the refusal to seek obstetric care in the health institution an initiative of the woman or family members. In the second delay, geographic factors and poor road infrastructure made access to health services difficult. In the third delay, the care conditions in the health institutions implied a reduced quality of care. The applicability of the model makes it possible to demonstrate the barriers faced by women in the search for obstetric care and to visualize contexts that need interventional actions to face the problem.

摘要：本综述旨在梳理现有科学文献中关于三延误模型（Three Delays Model）在孕产妇死亡率背景下，针对因果因素与干预措施应用的相关证据。本研究为整合性文献综述，检索范围无时间限制，共覆盖7个数据库，检索主题词包括孕产妇死亡率、妊娠并发症、孕产妇死亡，关键词为三延误模型。最终共纳入15项研究进行分析。首个延误环节作为孕产妇死亡的关键决定因素尤为突出，具体表现为女性或其家属自主拒绝前往医疗卫生机构寻求产科护理。在第二个延误环节中，地理区位因素与薄弱的道路基础设施阻碍了孕产妇获取医疗卫生服务。第三个延误环节则体现为医疗卫生机构内的护理条件不佳，导致护理服务质量下降。该模型的应用能够清晰展现女性在寻求产科护理时所面临的各类障碍，并可明确需采取干预措施以应对该问题的相关场景。