Why SAFE Works: A Model for Sustainably Reducing the Three Delays

SAFE's model is based on the belief that no woman should die bringing life into the world, and that no child should die before his/her life has really begun. We believe that basic healthcare during pregnancy, delivery, and early childhood is a human right, and we believe that nonprofit organizations providing services should be accountable to those they serve.


We achieve our vision by utilizing a combination of community-based and facility-based interventions to reduce the Three Delays for women and children in the first 1,000 days of life. The Three Delays is a model originally developed in the 1990s as a way to understand the environment surrounding maternal mortality, and has been used in countries across the world to understand and improve maternal mortality. The Three Delays include:

Delays in Seeking Care



Delays in Accessing Care

The Second Delay

Delays in Receiving Care


Third Delay

Why the "first 1,000 days"? The first 1,000 days--conception through the 2nd birthday--is a period of vital development in a child's life. Health and development during these early years can influence health and development for the rest of a person's life. Maternal health, nutrition, and behavior before, during and after birth all relate directly to child health in the first 1000 days, as does maternal care-giving after birth. By targeting maternal healthcare and behavior, SAFE is able to have long-lasting impact in both maternal and child health.


Why the Three Delays? In short: because it makes sense! The Three Delays model is incredibly useful in understanding the ways that a woman's or child's environment can help or hinder her/his health and survival. It recognizes and emphasizes the importance of addressing ALL three types of delays, instead of just one. It has been well-validated across the world, and allows us to get real data to guide real work for real impact in maternal and child survival.


What is "community-based"? At the center of SAFE's model is the belief that local people living in poverty have the right to be involved in the health and development processes in their communities, and that they must and can be an integral partner in improving those conditions. SAFE strives to involve the communities and health facilities we serve as the driving agents of change, throughout the process of understanding maternal and child health, identifying problems, and developing and implementing solutions.


Why SAFE? SAFE is the only organization we know of that extends the Three Delays model to address maternal and child health and survival in the first 1,000 days of life, and uses both community-based and health systems strengthening approaches to identify and solve Three Delay problems.