Table 3 Recognition, decision-making, and care-seeking by case type

Maternal death

Variable depending on symptom; often only when symptoms are very severe and woman’s daily functioning is affected

Female relatives, neighbors, husbands (3 cases)

Husbands, other family members (husband’s brothers, sisters, or mother), or neighbors if husband is absent

9 of 10 cases went to health facility; 8 of the 9 within 24 h

Spiritual care (prayers and tofi) used in 3 of 10 cases, contributed to delays in care-seeking at facility

6 of 9 cases faced significant barriers at the health facility level

Perceived PPH

Quick (blood is very obvious)

Female relatives, TBAs; no husbands were involved

Female relatives, TBAs; only a few husbands (when involved usually together with co-wives)

5 of 10 cases went to a health facility

Fewer barriers at health facility (no long waits)

Neonatal death

Variable; some symptoms such as paleness and constipation were not considered to be severe

Mother; sometimes mother’s mother or co-wives were also involved. Husbands were never involved

Mostly the mother or mother’s mother; only a few husbands; health worker in one case

3 of 10 cases went to a health facility

Symptom progression and death occur too quickly for care-seeking

Traditional medicine impeded care-seeking

2 of 3 cases faced some barriers at the health facility level (long waits and multiple referrals)

Neonatal illness

Variable; quicker when symptoms are specific and visible

Mother first; she then called for husband’s opinion

Husbands (in 8 of 10 cases)

5 of 10 cases went to a health facility

Longer delays between symptom recognition and care-seeking

Few delays at the health facility level