Assessing the effectiveness of the ‘three-delays’ model Towards maternal health and community development in the Peri-urban settlements of Masaka district, Uganda

Abstract

This study assessed the effectiveness of the Three-Delay Model in improving maternal health outcomes and promoting community development in peri-urban settlements of Masaka District, Uganda. The model addresses three critical delays in accessing emergency obstetric care: the decision to seek care, reaching a healthcare facility, and receiving adequate treatment—factors that significantly influence maternal and neonatal survival. A mixed- methods design was employed, integrating quantitative surveys with qualitative in-depth interviews and focus group discussions among women of reproductive age, healthcare providers, and community leaders. The findings showed that implementation of the Three-Delay Model was associated with a 20% increase in antenatal care attendance, a 15% rise in skilled birth attendance, and improved knowledge of reproductive health in over 70% of respondents. Community engagement initiatives also strengthened local support systems for maternal health. However, persistent barriers—including socio-cultural norms discouraging facility births, limited transport infrastructure, and inadequate staffing—continued to impede optimal outcomes. The study concludes that while the Three-Delay Model significantly improves maternal healthcare utilization and community participation, its long-term success requires targeted investments in transport, health workforce capacity, and culturally sensitive health education. These findings provide actionable insights for policymakers, healthcare practitioners, and development partners seeking to enhance maternal health in similar peri-urban contexts.