Healthcare Access and Maternal Mortality: Transportation as a Critical Factor in Emergency Obstetric Care

Abstract

Maternal mortality: it is a very serious public health topic in geographically isolated and disadvantaged (GIDA) communities in the Philippines, where geographical isolation, a lack of infrastructure and transport severely delay emergency obstetric care. National maternal health programs notwithstanding, local and context-specific evidence is still necessary, as preventable maternal deaths are still occurring. The proposed study was based on the aim of investigating the issues facing emergency obstetric care during transport in Barangay Cagnipa, Garchitorena, Camarines Sur, and determining the community informed solutions on the barriers to timely access to emergency obstetric care. Data were gathered based on a phenomenologically informed qualitative case study design guided by the Three Delays Model and enacted through the in-depth-interviews, focus group discussions, key informant interviews, and field observations by collecting data using 30 purposely sampled participants. The four themes identified through thematic analysis consisted of: (1) extreme transportation factors such as geographic isolation, weather dependent sea travel and unavailable vehicles and high costs of transport; (2) cultural beliefs and mistrust in institutional care making care-seeking delayed; (3) the systemic limitations live up to healthcare such as poor quality in supplies, facility preparedness, and low referral systems, (4) the restrained emergency response at the community and municipal level. These results indicate that transportation barriers work alongside her socio-cultural and health system to increase delays and prevent avoidable maternal deaths. The research paper provides novel localized qualitative data of the experience of transport-related delays in a remote Philippine barangay and offers community-driven-based emergency transport, enhanced referral coordination, and culturally-sensitive maternal health literacy as community-oriented strategic interventions that may enhance maternal outcomes in remote, geographically isolated communities.