Assessment of the quality of care in Maternity Waiting Homes (MWHs) in Mulanje District, Malawi

Suwedi-Kapesa, Leticia Chimwemwe; Nyondo-Mipando, Alinane Linda

doi:10.4314/mmj.v30i2.10

Cited by 13 publications

(21 citation statements)

References 16 publications

(22 reference statements)

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“…The provision of food at MWHs was heterogeneous. A study from Ethiopia reported that more than half of MWH users responded food was not affordable while staying at MWH [ 16 ] which was consistent with the findings from the studies in different countries found that the availability of food was the main reason women agreed or chose to use a MWH [ 15 , 17 - 20 ] or a barrier for MWH utilization [ 6 , 21 ].…”

Section: Discussionsupporting

confidence: 64%

“…The similarity might be due to the MWHs sharing resources with the health facilities. A Zambian study reported that the majority of MWH users had access to water, electricity and a toilet [ 14 ], but as study from Malawi reported that MWH users could not access reliable water or electricity [ 15 ]. The provision of food at MWHs was heterogeneous.…”

Section: Discussionmentioning

confidence: 99%

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Essential services provided and costs of facility-based maternity waiting homes in Ethiopia

Getachew

Liabsuetrakul

2021

Pan Afr Med J

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Introduction the objective was to describe establishment cost, essential services provided and operating costs of maternity waiting homes (MWH) in Ethiopia. Methods a cross-sectional study was carried out from December 2017 to June 2018 in eight health facilities with maternity waiting homes (MWH) in the Gurage Zone of Ethiopia. MWH users exit interviews and observational checklists were used to collect data on essential services provided. Cost-related data were retrieved from relevant records in the health facilities. Results most clinical services and basic amenities were available and provided for MWH users. The average capital costs of a MWH were $2,245 US with fixed costs of $1,476 US per year. The personnel cost for a MWH was $1,439 US per year. The average annual running cost of a MWH was $1,303 US per year. The average estimated MWH utilization and delivery costs was $16.9 US per woman. Conclusion most MWHs provided essential clinical services and basic amenities. The majority of the cost of a MWH was attributed to building construction costs. If building cost is annualized, the unit cost of a MWH service is in an acceptable range which encourage government considering expansion of the service in rural area.

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Section: Discussionsupporting

confidence: 64%

Section: Discussionmentioning

confidence: 99%

Essential services provided and costs of facility-based maternity waiting homes in Ethiopia

Getachew

Liabsuetrakul

2021

Pan Afr Med J

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“…MWH users perceived MWHs as a resting place, where women could take a break from their household and domestic tasks, which was perceived as beneficial before giving birth [ 13 , 23 , 38 – 41 , 45 , 48 , 49 ]. All subgroups felt they had easier access to health services when using the MWH, including better monitoring by health staff and easier transfer to higher-level facilities when complications occurred [ 7 , 12 , 19 , 24 , 35 , 37 , 39 , 41 , 42 , 50 – 53 ]. Other incentives for MWH users were health education [ 34 , 49 , 54 ], free lodging [ 13 , 39 ], the possibility of avoiding negative experience with home births [ 37 , 43 ], the benefits of sharing experiences and doing tasks together with other women [ 23 , 38 , 40 , 41 , 46 , 50 , 55 ] and the possibility of learning a new skill, such as sewing or gardening [ 13 ].…”

Section: Resultsmentioning

confidence: 99%

Stakeholders’ perspectives on the acceptability and feasibility of maternity waiting homes: a qualitative synthesis

van Braam,

McRae,

Portela

et al. 2023

Reprod Health

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Background Maternity waiting homes (MHWs) are recommended to help bridge the geographical gap to accessing maternity services. This study aimed to provide an analysis of stakeholders’ perspectives (women, families, communities and health workers) on the acceptability and feasibility of MWHs. Methods A qualitative evidence synthesis was conducted. Studies that were published between January 1990 and July 2020, containing qualitative data on the perspectives of the stakeholder groups were included. A combination of inductive and deductive coding and thematic synthesis was used to capture the main perspectives in a thematic framework. Results Out of 4,532 papers that were found in the initial search, a total of 38 studies were included for the thematic analysis. Six themes emerged: (1) individual factors, such as perceived benefits, awareness and knowledge of the MWH; (2) interpersonal factors and domestic responsibilities, such as household and childcare responsibilities, decision-making processes and social support; (3) MWH characteristics, such as basic services and food provision, state of MWH infrastructure; (4) financial and geographical accessibility, such as transport availability, costs for MWH attendance and loss of income opportunity; (5) perceived quality of care in the MWH and the adjacent health facility, including regular check-ups by health workers and respectful care; and (6) Organization and advocacy, for example funding, community engagement, governmental involvement. The decision-making process of women and their families for using an MWH involves balancing out the gains and losses, associated with all six themes. Conclusion This systematic synthesis of qualitative literature provides in-depth insights of interrelating factors that influence acceptability and feasibility of MWHs according to different stakeholders. The findings highlight the potential of MWHs as important links in the maternal and neonatal health (MNH) care delivery system. The complexity and scope of these determinants of utilization underlines the need for MWH implementation strategy to be guided by context. Better documentation of MWH implementation, is needed to understand which type of MWH is most effective in which setting, and to ensure that those who most need the MWH will use it and receive quality services. These results can be of interest for stakeholders, implementers of health interventions, and governmental parties that are responsible for MNH policy development to implement acceptable and feasible MWHs that provide the greatest benefits for its users. Trial registration Systematic review registration number: PROSPERO 2020, CRD42020192219.

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“…Medical doctors were in short supply in the MoH and most clinical care was provided by clinical officers and clinical technicians, para-medical staff holding 4-year medical degrees or 3-year diplomas, respectively (Jiskoot, 2008;van Amelsfoort et al, 2010), or nurse-midwives. To promote facility births, maternity wards in district hospitals and some health centers also functioned as waiting homes, with expectant mothers admitted up to 1 month prior to their estimated delivery dates (Singh et al, 2018;Suwedi-Kapesa & Nyondo-Mipando, 2018).…”

Section: Health Care In the Republic Of Malawimentioning

confidence: 99%

Culture’s Place in Quality of Care in a Resource-Constrained Health System: Comparison Between Three Malawi Districts

et al. 2021

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Public health scholars describe “culture of quality” in terms of desired values, attitudes, and practices, but this literature rarely includes explicitly stated theories of culture formation. In this article, we apply Fredrik Barth’s transactional model to demonstrate how taking a theory-centered approach can help to identify what would be necessary to foster “cultures of quality” outlined in the public health literature. We draw on data from a study of the Republic of Malawi’s Performance and Quality Improvement for Reproductive Health initiative. These data were generated in 2017–2018 through a 6-month organizational ethnography in three facilities selected to represent a range of districts with differing social and economic contexts. Our analysis revealed facility-level organizational cultures in which staff valued providing care, but responded to structural constraints by normalizing divergence from quality-of-care protocols. These findings indicate that sustaining a quality-oriented organizational culture requires addressing underlying conditions that generate routine experiences and practices.

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Assessment of the quality of care in Maternity Waiting Homes (MWHs) in Mulanje District, Malawi

Cited by 13 publications

References 16 publications

Essential services provided and costs of facility-based maternity waiting homes in Ethiopia

Essential services provided and costs of facility-based maternity waiting homes in Ethiopia

Stakeholders’ perspectives on the acceptability and feasibility of maternity waiting homes: a qualitative synthesis

Culture’s Place in Quality of Care in a Resource-Constrained Health System: Comparison Between Three Malawi Districts

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