A New Use for an Old Tool: Maternity Waiting Homes to Improve Equity in Rural Childbirth Care. Results from a Cross-sectional Hospital and Community Survey in Tanzania

Overview

Journal Health Policy Plan

Date 2017 Oct 18

PMID 29040509

Citations 30

Authors

Piera Fogliati

Manuela Straneo

Sabina Mangi

Gaetano Azzimonti

Firma Kisika

Giovanni Putoto

Affiliations

Soon will be listed here.

Abstract

Limited quality of childbirth care in sub-Saharan Africa primarily affects the poor. Greater quality is available in facilities providing advanced management of childbirth complications. We aimed to determine whether Maternity Waiting Homes (MWHs) may be a tool to improve access of lower socio-economic women to such facilities. Secondary analysis of a cross-sectional hospital survey from Iringa District, Tanzania was carried out. Women who delivered between October 2011 and May 2012 in the only District facility providing comprehensive Emergency Obstetric Care were interviewed. Their socio-economic profile was obtained by comparison with District representative data. Multivariable logistic regression was used to compare women who had stayed in the MWH before delivery with those who had accessed the hospital directly. Out of 1072 study participants, 31.3% had accessed the MWH. In multivariable analysis, age, education, marital status and obstetric factors were not significantly associated with MWH stay. Adjusted odds ratios for MWH stay increased progressively with distance from the hospital (women living 6-25 km, OR 4.38; 26-50 km, OR 4.90; >50 km, OR 5.12). In adjusted analysis, poorer women were more likely to access the MWH before hospital delivery compared with the wealthiest quintile (OR 1.38). Policy makers should consider MWH as a tool to mitigate inequity in rural childbirth care.

Citing Articles

Implementation fidelity of a multisite maternity waiting homes programme in rural Zambia: application of the conceptual framework for implementation fidelity to a complex, hybrid-design study.

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Utilization and determinants of maternity waiting homes among pastoralist mothers in Dire district, southern Ethiopia: a mixed-methods study.

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Maternity waiting home utilization among women who gave birth in the pastoralist communities of Borana Zone, Ethiopia: A community-based mixed-method study design.

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Utilization of pregnant women waiting area and associated factors among mothers at Damboya District, Kembata Tembaro Zone, Southern Ethiopia.

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Inequalities in use of hospitals for childbirth among rural women in sub-Saharan Africa: a comparative analysis of 18 countries using Demographic and Health Survey data.

Straneo M, Hanson C, van den Akker T, Afolabi B, Asefa A, Delamou A BMJ Glob Health. 2024; 9(1).

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