By PPH Foundation

Poor road conditions during the rainy season are increasing the risk of postpartum haemorrhage deaths by delaying women’s access to emergency obstetric care. Research shows that barriers in transportation infrastructure and long travel times are major contributors to delays in reaching skilled maternal health services, a situation that can turn manageable bleeding into a life‑threatening emergency if care is not received in time. Delays of even 30–60 minutes significantly increase the odds of severe outcomes for pregnant women experiencing complications.

Studies from sub‑Saharan Africa and urban settings underline this risk. In Lagos, Nigeria, women who had to travel 10–29 minutes to reach a hospital had more than double the odds of poor maternal outcomes compared with those with shorter travel times, with risk increasing further for longer journeys. A 2025 study in Addis Ababa found that only 35.7 percent of women used ambulances during obstetric emergencies, and an average travel time of about 51 minutes was common, with 27 percent of mothers experiencing transport delays.

Poor roads, flooding, and washed‑out bridges during rains disrupt not only travel but also supply chains for essential medicines, blood products, and emergency equipment. These factors compound what researchers refer to as the “second delay”; the time it takes to reach a facility with capacity to manage complications. In many low‑resource settings, poorly maintained roads, lack of transport options, and seasonal weather effects are consistently cited as key barriers to timely emergency care.

Prof Julius Ogeng’o, Co‑Lead of the End PPH Initiative, underscores the urgency of addressing infrastructure barriers: “When roads are impassable, even the best clinical preparedness cannot reach a mother in time. Poor roads in the rainy season create delays that directly contribute to devastating outcomes from postpartum haemorrhage.”

To mitigate these risks, communities and health systems must prioritize solutions such as emergency transport schemes, pre‑positioning lifesaving supplies, and community birth preparedness plans that account for transport challenges during rains. Improving road access and referral coordination isn’t only about convenience; it’s about survival for mothers facing obstetric emergencies.

Sources
Sources

Okwaraji YB, Cousens S, Berhane Y, Mulholland K, Edmond K. Effect of geographical access to health facilities on maternal and neonatal outcomes in sub-Saharan Africa. BMJ Global Health, 2016, 1(1)

Alemayehu M, Mekonnen W, Medhanyie AA. Delay in reaching health facilities and associated factors among mothers experiencing obstetric emergencies in Addis Ababa, Ethiopia. BMC Pregnancy and Childbirth, 2025, 25(1)

Thaddeus S, Maine D. Too far to walk, maternal mortality in context, the three delays model. Social Science and Medicine, 1994, 38(8)