Table 3 Summary of cross-country findings

 Maternal

Strong recognition of symptoms of excessive bleeding

Families able to assess severity of perceived PPH

Non-bleeding signs/symptoms not as easily recognized and varies by country

Recognition of severity of perceived PPH usually triggers immediate care-seeking, but not necessarily for other illnesses

Illness generally attributed to biomedical causes

Clusters of signs/symptoms may aid in recognition of severity as well as past experience with similar signs/symptoms

 Newborn

Variable recognition of signs of newborn illness

Severity more likely to be acknowledged with longer duration, but poor recognition of risk of rapid decline

Recognition of severity of illness does not necessarily precipitate immediate care seeking

Illness often attributed to supernatural causes

 Maternal

Key decision makers are husband, mother-in-law, elders

Perceived severity speeds up decision making

Perceived outcome, or belief in unfavorable outcome does not discourage decision to seek care

Community programs (e.g., self-help groups, savings groups) can aid in decision-making

Cultural norms of post-partum seclusion fosters decision-making towards home-based care

Perceived cause (biomedical vs supernatural) influences decision making (skilled vs traditional care)

 Newborn

Key decision makers are mother, mother-in-law, older woman

Perceived severity does not necessarily result in prompt decision-making

Perceptions that there is nothing to be done does influence decision to seek care

 Maternal

Care is sought outside the home except in cases of cultural norms of post-partum seclusion

In most cases, skilled care sought (although traditional/ spiritual care can also be sought)

Several points of care accessed reflecting supply side failures

Perceived and actual poor quality of facility care does not discourage care-seeking

Trusted community based workers are consulted in care-seeking process

 Newborn

Care more likely to be brought into the home as a first step

Non-skilled care often sought, especially if perceived supernatural cause

Community-based workers are generally not viewed as resources for newborn illness