Background: Maternal delays in utilization of emergency obstetric care are impacting on a high maternal mortality, especially in the poor resource countries including Ethiopia. Different strategies are designed and employed to reduce those maternal delays, and one of such strategies employed to overcome the geographic barriers and improve maternal and neonatal health outcomes is utilization of maternity waiting homes (MWHs). Studies related to the utilization of MWHs and associated factors are limited in Ethiopia and there were none in the study area. Objective: The aim of this study was to assess the utilization of maternity waiting homes and associated factors. Methods and Materials: A community-based cross-sectional study design was conducted, using multistage sampling technique. Logistic regression analysis with 95% CI for odds ratio (OR) was used to identify significant factors. Results: A total of 379 women participated in this study, making a response rate of 85%. Of the total participants, 42.5% (95% CI=38-48) of women utilized MWHs. After controlling for potential confounders, women's decision-making capacity (AOR=12.74; 95% CI=6.18-26.26), women having someone who can care for their children and/or husband at home (AOR=2.71; 95% CI=1.44-5.09), MWHs offering food service (AOR=4.03; 95% CI=2.07-7.85), offering and/or allowing women to practice their own cultural ceremony (allowing to cook their own food type, porridge, coffee, etc) (AOR=9.55; 95% CI=4.45-20.47), and women's attitude towards MWHs (AOR=0.09; 95% CI=0.03-0.23) were factors significantly associated with the utilization of MWHs. Conclusion: Compared to its contribution in reducing maternal and perinatal mortality, the utilization of MWHs was low in this study area. The integration of culturally sensitive and supportive maternity services, along with community participatory approach, would increase utilization of MWHs and consequently contribute in achieving the SDGs related to maternal and neonatal health.
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