Personal and environmental factors associated with the utilisation of maternity waiting homes in rural Zambia

Abstract

BackgroundAlthough the association between the presence of maternity waiting homes (MWHs) and the personal and environmental factors that affect the use of MWHs has been explained in qualitative terms, it has never been tested in quantitative terms. The aim of this study was to test the association between the presence of MWHs and personal and environmental factors that affect the use of MWHs.MethodsA cross-sectional study was conducted using an interviewer-administered questionnaire from 1st July to 31st August, 2014 among 340 women of reproductive age in 15 rural health centres in Kalomo district, Zambia. Tests of association (chi square, logistic regression analysis, odds ratio) were conducted to determine the strength of the association between the presence of MWHs and personal and environmental factors. Differences between respondents who used MWHs and those who did not were also tested.ResultsCompared to respondents from health centres without MWHs, those from centres with MWHs had higher odds of expressing willingness to use MWHs (adjusted odds ratio [aOR] = 4.58; 95% confidence interval [CI]:1.39–15.17), perceived more benefits from using a MWH (aOR =8.63; 95% CI: 3.13–23.79), perceived more social pressure from important others to use MWH (aOR =27.09; 95% CI: 12.23–60.03) and higher personal risk from pregnancy and childbirth related complications (aOR =11.63; 95% CI: 2.52–53.62). Furthermore, these respondents had higher odds of staying at a health centre before delivery (aOR =1.78; 95% CI: 1.05–3.02), giving birth at a health facility (aOR = 3.36; 95% CI: 1.85–6.12) and receiving care from a skilled birth attendant (aOR =3.24; 95% CI: 1.80–5.84). In contrast, these respondents had lower odds of perceiving barriers regarding the use of MWHs (aOR =0.27; 95% CI: 0.16–0.47). Factors positively associated with the use of MWHs included longer distances to the nearest health centre (p = 0.004), higher number of antenatal care (ANC) visits (p = 0.001), higher proportions of complications during ANC (p = 0.09) and women’s perception of benefits gained from staying in a MWH while waiting for delivery at the health centre (p = 0.001).ConclusionThese findings suggest a need for health interventions that focus on promoting ANC use, raising awareness about the risk and severity of pregnancy complications, promoting family and community support, and mitigating logistical barriers.

Association of maternity waiting home utilization with women's perceived geographic barriers and delivery complications in Ethiopia

“…The longer the travel time, the higher the number of women who used an MWH. Similar findings have been reported from Zambia, Ethiopia, and Nepal in studies which found that MWH users lived farther from the hospital attached to the MWH relative to women who were directly admitted to the hospital. Our results corroborate the belief that increased availability of MWHs would decrease geographical barriers for women to access health facilities .…”

Intention to Use Institutional Delivery and Associated Factors among ANC Attendants in Wollaita Soddo Town, Southern Ethiopia: A Cross-Sectional Community Based Study, Application of Theory of Planned Behavioral Model

“…This study showed that among psychosocial variables, attitude and subjective norms significantly affect the odds of intending to utilize institutional delivery among ANC attendants in contrast to study conducted in Kalomo Zambia which identified women's perceived behavioral control as one of the most important factors influencing mothers intention to utilize institutional delivery among ANC followers [13]. This difference might be due to women's low level awareness regarding institutional delivery service utilization in the study area.…”

“…All instruments for this study were tailored from diverse literature and were modified to fit the institutional delivery utilization behavior sphere [9][10][11][12][13]. The questionnaire was based on variables included in the theory of RAA/TPB.…”

Maternity waiting homes as component of birth preparedness and complication readiness for rural women in hard-to-reach areas in Ethiopia

“…This study showed that women in the lower wealth quintiles (1st and 2nd ) were more likely to use MWH services than those women in the highest (5th ) quantile. Similar ndings have also been reported by studies conducted in Gurage zone, Central Ethiopia, Tanzania, Zambia and Malawi, all of which highlighted that poorer women were more likely to use MWH services than women in the wealthiest quintile [14,[39][40][41][42]. The possible reason might be that staying in MWHs may be the only means the poorer women could access obstetric care and overcome delay in reaching the HIs as a result of exorbitant transportation cost and poor road condition.…”