Women living in the region under an emergency command post are experiencing delays in reaching health facilities: a multicenter cross-sectional study

Abstract<br> Introduction The time between seeking emergency care and receiving the first healthcare service is referred to as<br> delays in reaching health facilities. Delay in reaching health facilities had three main sub-themes in different studies.<br> These include (i). Availability of transportation and infrastructure, (ii). Distance from health facilities and (iii). Lack of<br> finance for transportation. Although there are plenty of findings about maternal delays in reaching health facilities,<br> studies do not address the delay situation of women in conflict zones all over the world. In Ethiopia, specifically, we<br> saw women delayed in healthcare service due to restricted movement and closure of roads, even for ambulances, at<br> night time.<br> Methods A multi-center cross-sectional study was conducted among mothers attending public health facilities<br> in the south Gondar zone, Ethiopia from September 01/2023 to April 30/2024. The data was collected by four BSc<br> degree-holder midwives, using structured questionnaires after training was given for a day in each hospital. A pretest<br> using 5% of the sample size was conducted. Descriptive statistics, and multivariable logistic regression analyses<br> were used to identify factors associated with delays in reaching health facilities. Variables having p-value ≤ 0.2 in the<br> bi-variable analysis were fitted into multiple logistic regression models.<br> Result The prevalence of delay in reaching health facilities among women who are living in the region of<br> emergency command post was 54.9% CI (42.04-59.87%). Living in rural areas, non-availability of public transport<br> during the armed conflict, labor onset at nighttime, road closures by the armed forces, and non-availability of<br> ambulances were the factors that contributed to the delay during the emergency command post.<br> Conclusion The magnitude of delay in reaching health facilities among women who are living in the region of<br> emergency command post was high.<br> Keywords Delay, Command-post, Conflict, Ethiopia, Women<br>