Maternity Waiting Homes as Part of an Integrated Program for Maternal and Neonatal Health Improvements: Women's Lives Are Worth Saving

Vermeiden, Tienke; Stekelenburg, Jelle

doi:10.1111/jmwh.12618

Cited by 17 publications

(20 citation statements)

References 20 publications

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“…Mgawadere et al [ 26 ] stress that quality of care at health facilities in Malawi must be improved in efforts to prevent maternal deaths. Overall, authors have noted the importance of ensuring that the MWHs are attached to health facilities that provides high quality care [ 12 , 27 ]. Another limitation is that there could be some bias in the results on satisfaction with the MWH structure and environment.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of a maternity waiting home and community education program in two districts of Malawi

Singh

Speizer

Kim

et al. 2018

BMC Pregnancy Childbirth

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BackgroundThe implementation of Maternity Waiting Homes (MWHs) is a strategy to bring vulnerable women close to a health facility towards the end of their pregnancies. To date, while MWHs are a popular strategy, there is limited evidence on the role that MWHs play in reaching women most in need. This paper contributes to this topic by examining whether two program-supported MWHs in Malawi are reaching women in need and if there are changes in women reached over time.MethodsTwo rounds of exit interviews (2015 and 2017) were conducted with women within 3 months of delivery and included both MWH users and non-MWH users. These exit interviews included questions on sociodemographic factors, obstetric risk factors and use of health services. Bivariate statistics were used to compare MWH users and non-MWH users at baseline and endline and over time. Multivariable logistic regression was used to determine what factors were associated with MWH use, and Poisson regression was used to study factors associated with HIV knowledge. Descriptive data from discharge surveys were used to examine satisfaction with the MWH structure and environment over time.ResultsPrimiparous women were more likely to use a MWH compared to women of parity 2 (p < 0.05). Women who were told they were at risk of a complication were more likely to use a MWH compared to those who were not told they were at risk (p < 0.05). There were also significant findings for wealth and time to a facility, with poorer women and those who lived further from a facility being more likely to use a MWH. Attendance at a community event was associated with greater knowledge of HIV (p < 0.05).ConclusionsMWHs have a role to play in efforts to improve maternal health and reduce maternal mortality. Education provided within the MWHs and through community outreach can improve knowledge of important health topics. Malawi and other low and middle income countries must ensure that health facilities affiliated with the MWHs offer high quality services.Electronic supplementary materialThe online version of this article (10.1186/s12884-018-2084-7) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Evaluation of a maternity waiting home and community education program in two districts of Malawi

Singh

Speizer

Kim

et al. 2018

BMC Pregnancy Childbirth

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“…This is the easiest way to decrease the complication related to child birth through avoiding the second delay. It decreases barriers, which includes: distance, geography, transport, cost of transport and communication between referral points, that inhibit access to service, [ 2 , 3 , 5 ].…”

Section: Introductionmentioning

confidence: 99%

Role of maternity waiting homes in the reduction of maternal death and stillbirth in developing countries and its contribution for maternal death reduction in Ethiopia: a systematic review and meta-analysis

Dadi

Bekele

Kasaye

et al. 2018

BMC Health Serv Res

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BackgroundEvery family expect to have a healthy mother and new born baby after pregnancy. Especially for parents, pregnancy is a time of great anticipation. Access to maternal and child health care insures safer pregnancy and its outcome. MWHs is one the strategy. The objective was to synthesize the best available evidence on effectiveness of maternity waiting homes on the reduction of maternal mortality and stillbirth in developing countries.MethodsBefore conducting this review non-occurrences of the same review is verified. To avoid introduction of bias because of errors, two independent reviewers appraised each article. Maternal death and stillbirth were the primary outcomes. Review Manager 5 were used to produce a random-effect meta-analysis. Grade Pro software were used to produce risk of bias summary and summary of findings.ResultIn developing countries, maternity waiting homes users were 80% less likely to die than non-users (OR = 0. 20, 95% CI [0.08, 0.49]) and there was 73% less occurrence of stillbirth among users (OR = 0.27, 95% CI [0.09, 0.82]). In Ethiopia, there was a 91% reduction of maternal death among maternity waiting homes users unlike non-users (OR = 0.09, 95% CI [0.04, 0.19]) and it contributes to the reduction of 83% stillbirth unlike non-users (OR = 0.17, 95% CI [0.05, 0.58]).ConclusionMaternity waiting home contributes more than 80% to the reduction of maternal death among users in developing countries and Ethiopia. Its contribution for reduction of stillbirth is good. More than 70% of stillbirth is reduced among the users of maternity waiting homes. In Ethiopia maternity waiting homes contributes to the reduction of more than two third of stillbirths.Electronic supplementary materialThe online version of this article (10.1186/s12913-018-3559-y) contains supplementary material, which is available to authorized users.

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“…This is particularly important in preventing deaths related to haemorrhage, ruptured uterus and eclampsia, all of which can lead to rapid maternal death (i.e. within 48 h of onset) . We also saw an increase in the number of women diagnosed with complications of pregnancy at the hospital, mostly due to an increase in diagnosis of pre‐eclampsia.…”

Section: Discussionmentioning

confidence: 92%

“…In 2014, MSF carried out training and mentoring for the nurse‐midwives at SJH followed by training on ultrasound (USG) and caesarean section (C‐Section) in the fourth quarter of 2014. In addition to this, 36 staff members from SJH and referral PHC centres received an Advanced Life Support in Obstetrics (ALSO) course, an evidence‐based, multidisciplinary training programme that prepares maternity health care providers to better manage obstetric emergencies . Last, referral from SJH to the tertiary hospital was strengthened.…”

Section: Methodsmentioning

confidence: 99%

Removal of user fees and system strengthening improves access to maternity care, reducing neonatal mortality in a district hospital in Lesotho

Steele

Sugianto

Baglione³

et al. 2018

Tropical Med Int Health

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Objective Lesotho has one of the highest maternal mortality rates in the world. While at primary health care (PHC) level maternity care is free, at hospital level co‐payments are required from patients. We describe service utilisation and delivery outcomes before and after removal of user fees and quality of delivery care, and associated costs, at St Joseph's Hospital (SJH) in Roma, Lesotho. Methods We compared utilisation of delivery services, stillbirths and maternal and neonatal mortality for the periods before (1 July 2012 to 31 December 2013) and after (1 January 2014 to 30 June 2015) user fee removal through a retrospective chart review and estimated additional costs attributed to user fee removal from provider (hospital) and patient perspectives. Results Of 4715 deliveries 3855 were at SJH and 860 at PHC centres. Of women delivering at SJH 684 (18.5%) were ≤19 years and 894 (23.6%) were HIV positive. After user fee removal hospital deliveries increased by 49% — from 1547 to 2308 — and neonatal mortality decreased from 4.8 to 1.3 per 1000 live births (P = 0.033). Extrapolating costs to the entire country, 1 USD per capita per year would allow user fee removal at hospital level, the provision of free transport to/from and accommodation at hospital. Conclusion Removing user fees for hospital delivery care in Lesotho is feasible and affordable, and has the potential to improve maternal and neonatal outcomes by removing financial barriers to skilled birth attendants and increasing coverage of institutional deliveries.

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Maternity Waiting Homes as Part of an Integrated Program for Maternal and Neonatal Health Improvements: Women's Lives Are Worth Saving

Cited by 17 publications

References 20 publications

Evaluation of a maternity waiting home and community education program in two districts of Malawi

Evaluation of a maternity waiting home and community education program in two districts of Malawi

Role of maternity waiting homes in the reduction of maternal death and stillbirth in developing countries and its contribution for maternal death reduction in Ethiopia: a systematic review and meta-analysis

Removal of user fees and system strengthening improves access to maternity care, reducing neonatal mortality in a district hospital in Lesotho

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