Exploring the experience and challenges of maternity waiting homes in Jimma, southwest Ethiopia

Abstract

Background Establishing maternity waiting homes is a key strategy to address the geographic barrier to obstetric care access among women living in rural areas. In Ethiopia, maternity waiting homes have been in use for several years, with a sharp increase in the number of such facilities recently. However, there is little empirical evidence detailing the experiences and challenges faced by women during the implementation of this initiative in Ethiopia. Methods This study used a multiple case study design with qualitative data collection methods, and was conducted from October to November 2016. Data were collected using focus group discussions, in-depth interviews and direct observation of each maternity waiting home. All interviews and focus group discussions were recorded using a digital voice recorder. Data were transcribed and translated into English. The coding process and formation of thematic structure was assisted by Atlas ti7.5 computer software. Results The participants reported that they were satisfied and comfortable with the services at the maternity waiting homes, as were their husbands and community leaders. Facility, social and environmental challenges were identified as common barriers to the utilisation of maternity waiting homes by stakeholders at different levels. Healthcare providers reported common challenges at maternity waiting homes include a lack of basic utilities (water and electric supply), and overcrowding because of a shortage of space and lack of medical supplies. Some women reported that poor transportation services and the distance to facilities hindered the utilisation of maternity waiting homes. Conclusions There are social and facility challenges related to the use of maternity waiting homes in Ethiopia. Policymakers and health managers should work with relevant sectors to mitigate the effect of facility, social and environmental barriers and maximise the use of maternity waiting homes.

Benefits, barriers and enablers of maternity waiting homes utilization in Ethiopia: an integrative review of national implementation experience to date

“…Furthermore, it allows healthcare providers to convey health-related information, such as newborn feeding, family planning, and immunization to pregnant women at MWH. It also gives pregnant women the chance to discuss their experiences with one another and adopt behaviors that are crucial for safe motherhood [21,31,36].…”

“…Whereas other reported that physically, MWHs are available in some areas but do not provide all-encompassing services. As a result, women who planned to stay there were required to bring their food and basic household supplies from home, such as mattresses and kitchen utensils for the duration of their stay [14,21,31,35,36].…”

“…The refusal of a husband or parent to use MWH was demonstrated to be a barrier to MWH use. Pregnant women who desire to stay at MWH are expected to leave their children at home, and there is a societal view that leaving children alone at home without someone to support is a sign of a refusal of social responsibility [21,31,35,36,40].…”

A phenomenological qualitative study of male-partners perspectives of maternity waiting homes in rural Ethiopia

“…Some of the important barriers of women's access to MWHs were household chores and the fact that their use of MWHs depends largely on male-partners’ decisions [ 5 , 6 ]. Given the patriarchal dominance, final decisions regarding MWH use in Ethiopia is mainly made by male-partners [ 7 ].…”