Background: Lack of seeking appropriate care for ill mothers and neonates contributes to high mortality rates; therefore, a major challenge is the appropriate mix of strategies for demand creation as well as provision of services.

Objectives: To review observational and qualitative studies to identify factors associated with delays that lead to serious maternal and neonatal morbidity and mortality

Methods: Systematic review of observational and qualitative studies to identify factors and barriers associated with delays in seeking health care.

Results: A total of 151 observational and qualitative studies met the inclusion criteria. The review of observational and qualitative studies identified several social, cultural and health services related factors that contribute to delays in seeking health care. The review identified that timely recognition of danger signs, autonomy of decision making, availability of finances, accessibility of the health facility, and perceived quality of care are the necessary considerations when making the decision to seek formal care.

Conclusions: Effective implementation of identified strategies after controlling for other factors of delays would lead to significant improvement in mortality, morbidity and care seeking outcomes.

Funding: This review was part of doctoral thesis which was funded by University of Adelaide, Australia.