Maternity waiting homes and skilled delivery in Ethiopia: Review of strategy and implementation to drive sustainable development goals

Abstract

Improving maternal and child health is foundation for every nations, communities and families. Millennium Development Goals had applied various strategies to overcome the gaps resulted in maternal and child health morbidity and mortality from global to local levels. Among the strategies is maternity waiting home, an important tool-had been addressed those in need of access and hard/difficult to reach for skilled delivery. Consequently, the aim of this review is to narrate the existing strategies, summarized outcome and impact of maternity waiting homes in Ethiopia as well as make recommendations. Four databases were searched to access literatures; they are: Science Direct, Google Scholar, Open Access Journals Search Engine and PubMed. Published literatures and other library sources were explored to get unpublished works in the topic. Boolean connectors were used to connect the key words. Exclusion and inclusion criteria were established. From all databases, five literatures were identified, screened, and included; all were facility based studies. Three were cross sectional, one prospective and the other retrospective cohort in their design of study. Two cohorts studies claimed that there is difference between the outcome of perinatal and mothers following maternity waiting homes utilization. Cohort studies revealed that mothers who utilized maternity waiting homes are less likely to have negative health consequences; themselves and their perinatal. Findings from existing literatures show that there have been significant differences in maternal and perinatal mortality among maternity waiting homes utilizers and non-utilizers, with its own limitations; although no community or facility based studies were conducted. Consequently, it is vital to conduct community based randomized trial to examine the observable effect of maternity waiting homes in improvement of perinatal and maternal health.

<p>A Culturally Sensitive and Supportive Maternity Care Service Increases the Uptake of Maternity Waiting Homes in Ethiopia</p>

“…32 This, in turn, demonstrates establishing functional MWHs considerably contribute to prevent maternal and perinatal mortality. 10,30,33 Likewise, systematically reviewed studies in Ethiopia showed MWHs contributed to an 83% reduction in stillbirths and a 91% reduction in maternal deaths compared to women who did not attend MWHs. 6,10 This also illustrates the contribution of MWHs in achieving related SDGs, 34,35 in the poor countries like Ethiopia.…”

“…9 Studies reported MWHs have significant importance in reducing maternal and perinatal mortalities. 10 The WHO has endorsed MWHs since the 1950s as one component of a comprehensive package to reduce maternal morbidity and mortality, 11 primarily to be used in the LMICs to bridge the geographic barriers for women living far from health facilities, 7,12 considerably overcoming the three delays contributing to maternal mortality. 13,14 Ethiopia has implemented MWHs since 1976, 7 as more than 80% of people live rurally with limited access to skilled obstetric care, still experiencing high maternal and neonatal mortality, 15 while only 28% of women delivered by skilled health professionals, 16 entailing the need for addressing MWHs, among others.…”

Maternity waiting home Utilization and associated factors among women who gave birth in the Digelu and Tijo district of the Arsi Zone, Oromia, Ethiopia

“…The questionnaire used for MWH users and non-MWH users was different in content. To assure the quality of the data, properly designed data collection instruments were developed in English after thoroughly revising related literatures(3,8,12,14–17) and contextualized to suit to the research objective, local situations and language. The English version of the questionnaire was translated to Oromiffa and translated back to English to check consistency by language expert.…”

“…It introduced into developing countries in the 1960’s. MWHs are residential facilities located near a hospital or a health center to accommodate women in their final weeks of pregnancy to bridge the geographical gap (1–3). According to World Health Statistics 2015 released by the World Health Organization every year some 303,000 women die of complications during pregnancy or child-birth globally.…”

Determinants of Premature Rupture of Membranes Among Pregnant Women Admitted to Public Hospitals in Southern Ethiopia, 2020: A Hospital-Based Case–Control Study

“…Maternal waiting room (MWR): A home or residential facility near a hospital or a health center that offers emergency obstetric care (EmOC) with skilled birth attendants to women who are far from facilities and stayed there in their final weeks of pregnancy. 33 , 34 …”