Jody R Lori1, Michelle L Munro-Kramer2, Eden Ahmed Mdluli3, Gertrude K Musonda Mrs4, Carol J Boyd5. 1. Department of Health Behavior and Biological Sciences, University of Michigan, School of Nursing, 400 North Ingalls, Ann Arbor, MI 48109, USA. Electronic address: jrlori@umich.edu. 2. Department of Health Behavior and Biological Sciences, University of Michigan, School of Nursing, 400 North Ingalls, Ann Arbor, MI 48109, USA. Electronic address: mlmunro@umich.edu. 3. Africare House, 440 R Street, N.W., Washington, D.C. 20001, USA. Electronic address: eahmedmdluli@africare.org. 4. Africare Zambia, Flat A, Plot 2407/10 MBX, Off Twin Palm Road, Ibex Hill, Box 33921, Lusaka, Zambia. Electronic address: gmusonda@africare.org. 5. Department of Health Behavior and Biological Sciences, University of Michigan, School of Nursing, 400 North Ingalls, Ann Arbor, MI 48109, USA. Electronic address: caroboyd@umich.edu.
Abstract
BACKGROUND: maternity waiting homes (MWHs) are residential dwellings located near health facilities where women in the late stages of pregnancy stay to await childbirth and receive immediate postpartum services. These shelters help overcome distance and transportation barriers that prevent women from receiving timely skilled obstetric care. OBJECTIVE: the purpose of this study was to explore Zambian stakeholders' beliefs regarding the acceptability, feasibility, and sustainability of maternity waiting homes (MWHs) to inform a model for rural Zambia. DESIGN: a qualitative design using a semi-structured interview guide for data collection was used. SETTING: two rural districts in the Eastern province of Zambia. PARTICIPANTS: individual interviews were conducted with community leaders (n=46). Focus groups were held with Safe Motherhood Action Groups, husbands, and women of childbearing age in two rural districts in Zambia (n=500). MEASURES: latent content analysis was used to analyze the data. FINDINGS: participants were overwhelmingly in support of MWHs as a way to improve access to facility-based childbirth and address the barrier of distance. Data suggest that participants can describe features of high quality care, and the type of care they expect from a MWH. Stakeholders acknowledged the need to contribute to the maintenance of the MWH, and that community involvement was crucial to MWH sustainability. KEY CONCLUSIONS: access to facility childbirth remains particularly challenging in rural Zambia and delays in seeking care exist. Maternity waiting homes offer a feasible and acceptable intervention to reduce delays in seeking care, thereby holding the potential to improve maternal outcomes. IMPLICATIONS FOR PRACTICE: this study joins a growing literature on the acceptability, feasibility, and sustainability of MWHs. It is believed that MWHs, by addressing the distance and transportation barriers, will increase the use of skilled birth attendants, thereby reducing maternal and neonatal morbidity and mortality in rural, low resource areas of Zambia. We recommend that any initiative, such as MWHs, seeking to increase facility-based births with a skilled birth attendant also concurrently addresses any local deficiencies in quality of care.
BACKGROUND: maternity waiting homes (MWHs) are residential dwellings located near health facilities where women in the late stages of pregnancy stay to await childbirth and receive immediate postpartum services. These shelters help overcome distance and transportation barriers that prevent women from receiving timely skilled obstetric care. OBJECTIVE: the purpose of this study was to explore Zambian stakeholders' beliefs regarding the acceptability, feasibility, and sustainability of maternity waiting homes (MWHs) to inform a model for rural Zambia. DESIGN: a qualitative design using a semi-structured interview guide for data collection was used. SETTING: two rural districts in the Eastern province of Zambia. PARTICIPANTS: individual interviews were conducted with community leaders (n=46). Focus groups were held with Safe Motherhood Action Groups, husbands, and women of childbearing age in two rural districts in Zambia (n=500). MEASURES: latent content analysis was used to analyze the data. FINDINGS:participants were overwhelmingly in support of MWHs as a way to improve access to facility-based childbirth and address the barrier of distance. Data suggest that participants can describe features of high quality care, and the type of care they expect from a MWH. Stakeholders acknowledged the need to contribute to the maintenance of the MWH, and that community involvement was crucial to MWH sustainability. KEY CONCLUSIONS: access to facility childbirth remains particularly challenging in rural Zambia and delays in seeking care exist. Maternity waiting homes offer a feasible and acceptable intervention to reduce delays in seeking care, thereby holding the potential to improve maternal outcomes. IMPLICATIONS FOR PRACTICE: this study joins a growing literature on the acceptability, feasibility, and sustainability of MWHs. It is believed that MWHs, by addressing the distance and transportation barriers, will increase the use of skilled birth attendants, thereby reducing maternal and neonatal morbidity and mortality in rural, low resource areas of Zambia. We recommend that any initiative, such as MWHs, seeking to increase facility-based births with a skilled birth attendant also concurrently addresses any local deficiencies in quality of care.
Authors: Nancy A Scott; Jeanette L Kaiser; Taryn Vian; Rachael Bonawitz; Rachel M Fong; Thandiwe Ngoma; Godfrey Biemba; Carol J Boyd; Jody R Lori; Davidson H Hamer; Peter C Rockers Journal: BMJ Open Date: 2018-08-10 Impact factor: 2.692
Authors: Michelle L Munro-Kramer; Nancy Scott; Carol J Boyd; Philip T Veliz; Sarah M Murray; Gertrude Musonda; Jody R Lori Journal: Int J Gynaecol Obstet Date: 2018-09-05 Impact factor: 3.561
Authors: Kavita Singh; Ilene S Speizer; Eunsoo Timothy Kim; Clara Lemani; Jennifer H Tang; Ann Phoya Journal: BMC Pregnancy Childbirth Date: 2018-11-23 Impact factor: 3.007
Authors: Anne K Erickson; Safa Abdalla; Alice Serenska; Bete Demeke; Gary L Darmstadt Journal: BMC Pregnancy Childbirth Date: 2021-07-03 Impact factor: 3.007
Authors: Nancy A Scott; Taryn Vian; Jeanette L Kaiser; Thandiwe Ngoma; Kaluba Mataka; Elizabeth G Henry; Godfrey Biemba; Mary Nambao; Davidson H Hamer Journal: PLoS One Date: 2018-03-15 Impact factor: 3.240
Authors: Julie M Buser; Cheryl A Moyer; Carol J Boyd; Davy Zulu; Alice Ngoma-Hazemba; Jessy Taona Mtenje; Andrew D Jones; Jody R Lori Journal: Midwifery Date: 2020-02-29 Impact factor: 2.372