In this paper, Catherine reports the findings of a study which collected data from 433 women who sought care for obstetric complications in 9 health facilities in Kampala City. She found that the majority of women reported going directly to a facility that provided the required care, but a non-significant minority reported three or more steps before reaching the care they needed. Women’s care-seeking pathways included substantial delays and unnecessary steps. Some of the reasons for these were lack of money for transport, needing to receive permission from their husband before seeking care, and reflected inefficiencies in the referral system, including referrals from designated comprehensive emergency obstetric care facilities and direct referrals from lower-level facilities to the national referral hospital. Catherine and her co-author team call on policymakers and programmers to strengthen action across Kampala's metropolitan districts to meet women's needs for quality obstetric care, including through improving accountability mechanisms and coordination systems.
