ArticleBMJ global health2022
Travel of pregnant women in emergency situations to hospital and maternal mortality in Lagos, Nigeria: a retrospective cohort study.
Article in BMJ global health, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers.
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Who cites it
20 citing papers in PubMed, 36 citations in OpenAlex.
- Multistakeholder perspectives on geographical accessibility to emergency obstetric care in Benin City, Nigeria.African journal of emergency medicine : Revue africaine de la medecine d'urgence · 2026Article
- Inter-facility travel time and referral for emergency obstetric care in the 15 most populated cities of Nigeria: a spatial analysis.BMC global and public health · 2026Article
- Determinants of maternal transportation mode and travel time for timely emergency obstetric care in selected public hospitals, Addis Ababa, Ethiopia, 2025.AJOG global reports · 2026Article
- Risk-Stratified Screening for Perinatal Depression and Anxiety: Integrating Sexual Function, Self-Esteem, and Psychosocial Context.Diagnostics (Basel, Switzerland) · 2026Review
- Gaps and barriers preventing sustained delivery of HPV vaccination in Kano, Kaduna, and Lagos states: An exploratory qualitative study.PloS one · 2026Article
- Reporting maternal deaths in Anglophone West Africa: A media content analysis of articles published online between 2015 and 2025.PLOS global public health · 2026Article
- Big data in modelling geographical accessibility to healthcare: a scoping review protocol.BMJ open · 2025Article
- Emergency Obstetric Care Access Dynamics in Kampala City, Uganda: Analysis of Women's Self-Reported Care-Seeking Pathways.Global health, science and practice · 2024Article
- Inequalities in geographical access to emergency obstetric and newborn care.Bulletin of the World Health Organization · 2024Article
- Potential effects of a mobile stroke unit on time to treatment and outcome in patients treated with thrombectomy or thrombolysis: A Danish-German cross-border analysis.European journal of neurology · 2024Article
- Do current maternal health staffing and bed occupancy benchmarks work in practice? Results from a simulation model.BMJ public health · 2024Article
- Socio-spatial equity analysis of relative wealth index and emergency obstetric care accessibility in urban Nigeria.Communications medicine · 2024Article
- Maternal health care utilization following the implementation of the free maternal health care policy in Ghana: analysis of Ghana demographic and health surveys 2008-2014.BMC health services research · 2024Article
- Effects of community-based interventions for stillbirths in sub-Saharan Africa: a systematic review and meta-analysis.EClinicalMedicine · 2024Article
- Optimising availability and geographical accessibility to emergency obstetric care within a sub-national social health insurance scheme in Nigeria.Frontiers in health services · 2024Article
- A geospatial database of close-to-reality travel times to obstetric emergency care in 15 Nigerian conurbations.Scientific data · 2023Article
- Maternal Mortality in a Rural District of Pakistan and Contributing Factors.Maternal and child health journal · 2023Article
- Article
- Use of motorised transport and pathways to childbirth care in health facilities: Evidence from the 2018 Nigeria Demographic and Health Survey.PLOS global public health · 2022Article
- Leveraging big data for improving the estimation of close to reality travel time to obstetric emergency services in urban low- and middle-income settings.Frontiers in public health · 2022Article
Corrections and comments
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Authors and funding
10 authors at 8 institutions in 4 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionPrompt access to emergency obstetrical care (EmOC) reduces the risk of maternal mortality. We assessed institutional maternal mortality by distance and travel time for pregnant women with obstetrical emergencies in Lagos State, Nigeria.
methodsWe conducted a facility-based retrospective cohort study across 24 public hospitals in Lagos. Reviewing case notes of the pregnant women presenting between 1 November 2018 and 30 October 2019, we extracted socio-demographic, travel and obstetrical data. The extracted travel data were exported to Google Maps, where driving distance and travel time data were extracted. Multivariable logistic regression was conducted to determine the relative influence of distance and travel time on maternal death.
findingsOf 4181 pregnant women with obstetrical emergencies, 182 (4.4%) resulted in maternal deaths. Among those who died, 60.3% travelled ≤10 km directly from home, and 61.9% arrived at the hospital ≤30 mins. The median distance and travel time to EmOC was 7.6 km (IQR 3.4-18.0) and 26 mins (IQR 12-50). For all women, travelling 10-15 km (2.53, 95% CI 1.27 to 5.03) was significantly associated with maternal death. Stratified by referral, odds remained statistically significant for those travelling 10-15 km in the non-referred group (2.48, 95% CI 1.18 to 5.23) and for travel ≥120 min (7.05, 95% CI 1.10 to 45.32). For those referred, odds became statistically significant at 25-35 km (21.40, 95% CI 1.24 to 36.72) and for journeys requiring travel time from as little as 10-29 min (184.23, 95% CI 5.14 to 608.51). Odds were also significantly higher for women travelling to hospitals in suburban (3.60, 95% CI 1.59 to 8.18) or rural (2.51, 95% CI 1.01 to 6.29) areas.
conclusionOur evidence shows that distance and travel time influence maternal mortality differently for referred women and those who are not. Larger scale research that uses closer-to-reality travel time and distance estimates as we have done, rethinking of global guidelines, and bold actions addressing access gaps, including within the suburbs, will be critical in reducing maternal mortality by 2030.
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