Perinatal audit using the 3-delays model in western Tanzania

ObjectiveTo audit intrapartum fetal and early neonatal deaths of infants weighing ≥ 2000 g in a regional hospital in western Tanzania.MethodsThe 3-delays methodology was applied to a cohort of perinatal deaths from July 2002 to July 2004.ResultsThe 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 ≥ 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%.ConclusionFor 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.