Planning for Maternity Waiting Home Bed Capacity: Lessons from Rural Zambia

Vian, Taryn; Kaiser, Jeanette L; Ngoma, Thandiwe; Juntunen, Allison; Mataka, Kaluba; Bwalya, Misheck; Sakanga, Viviane I R; Rockers, Peter C.; Hamer, Davidson H.; Biemba, Godfrey; Scott, Nancy A.

doi:10.5334/aogh.3691

Cited by 2 publications

(4 citation statements)

References 32 publications

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“…Bed occupancy varies from time to time, and it is very hard to predict when the MWH will be full or not. Similar findings were observed in another study in Zambia where bed occupancy varied between 13% and 151% and planning for MWH capacity was very difficult [ 30 ]. Therefore, the MWH would need additional beds so that health providers can be more confident in admitting more women.…”

Section: Discussionsupporting

confidence: 88%

Provider and client perspectives on the use of maternity waiting homes in rural Rwanda

Tayebwa

Gatimu²,

Kalisa

et al. 2023

Global Health Action

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Background The World Health Organization recommends the implementation of maternity waiting homes (MWH) to reduce delays in access to obstetric care, particularly for high-risk pregnancies and mothers living far from health facilities, and as a result, several countries have rolled out MWHs. However, Rwanda has not implemented this recommendation on a large scale. There is only one MWH in the country, hence a gap in knowledge regarding the potential utilisation and benefits of MWHs. Objective To explore providers’ and clients’ perspectives on facilitators and barriers to the use of MWH in rural Rwanda. Methods We conducted a qualitative study to explore health providers’ and clients’ perspectives on facilitators and barriers to the use of MWH in Rwanda, between December 2020 and January 2021. We used key informant interviews and focus group discussions to collect data. Data were analysed using NVivo qualitative analysis software version 11. Results Facilitators included perceptions that the MWH offered either a peaceful and home-like environment, good-quality services, or timely obstetric services, and was associated with good maternal and neonatal outcomes. Barriers included limited awareness of the MWH among pregnant women, fear of health providers to operate the MWH at full capacity, women’s lack of autonomy, uncertainty over funding for the MWH, and perceived high user fees. Conclusion The Ruli MWH offers a peaceful environment for pregnant women while providing quality and timely obstetric care, resulting in positive maternal and neonatal outcomes for women. However, its existence and benefits are not widely known, and its use is limited due to inadequate resources. There is a need for increased awareness of the MWH among healthcare providers and the community, and lessons from this MWH could inform the scale up of MWHs in Rwanda.

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Section: Discussionsupporting

confidence: 88%

Provider and client perspectives on the use of maternity waiting homes in rural Rwanda

Tayebwa

Gatimu²,

Kalisa

et al. 2023

Global Health Action

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“…This may be achieved through simple rules whereby the earliest MWH move date resulting in a minimum specified P (SBA) value is recommended (in the case illustrated by Figure 4 for example, a minimum specified value of P (SBA) ≥ 90% in all cases would result in an individual recommendation of moving to the MWH 2 weeks before EDD). In areas where MWH bed capacity is restricted, one might adjust that minimum threshold value of P (SBA) in order to limit the possibility of MWH overcrowding and associated negative consequences 38 . Although MWH stay is the only intervention explicitly considered by this model, the predicted risk of delivery without SBA provided for the scenario without MWH stay may also motivate the advice or planning of alternative types of care access arrangements (e.g., alternative temporary residence, transportation access arrangements, engagement of local care professional) by either care professionals or individual women and their families.…”

Section: Discussionmentioning

confidence: 99%

“…This may be achieved through simple rules whereby the earliest MWH move date resulting in a minimum specified 𝑷(SBA) value is recommended (in the case illustrated by Figure 4 for example, a minimum specified value of 𝑷(SBA) ≥ 90% in all cases would result in an individual recommendation of moving to the MWH 2 weeks before EDD). In areas where MWH bed capacity is restricted, one might adjust that minimum threshold value of 𝑷(SBA) in order to limit the possibility of MWH overcrowding and associated negative consequences 38 .…”

Section: Discussionmentioning

confidence: 99%

“…The decisions affecting labour care pathway that are faced by pregnant women in resourcelimited settings (for example planned birth location, transportation arrangements, care provider engagement, planned move to health facility including MWH, arrangements for family work including income generation, food & water provision and child care) are thus potentially material to health, cognitively complex and psychologically difficult 5,[19][20][21]38 ; these decisions may also be strongly influenced by cultural beliefs and traditions. In this context we observe that pregnant women and those advising or caring for them typically have limited or no access to systematic guidance and information relevant to those decisions, let alone quantitative and/or evidence-based information.…”

Section: (Which Was Not Certified By Peer Review)mentioning

confidence: 99%

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A simple mathematical model and physical device to estimate a woman-specific probability of skilled birth assistance and associated benefit of maternity waiting home stay

Gallien,

Chen,

Zhang

et al. 2024

Preprint

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This paper presents a simple mathematical model and an associated physical device to predict (i) the risk that a woman’s active labor will begin without a skilled birth attendant based on her parity and anticipated time to access skilled care; and (ii) the extent to which that risk may be reduced by moving to a maternity waiting home some time before her expected due date. This tool is designed to facilitate more systematic discussions and better-informed decisions about labour care access arrangements during antenatal consultations.

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Planning for Maternity Waiting Home Bed Capacity: Lessons from Rural Zambia

Cited by 2 publications

References 32 publications

Provider and client perspectives on the use of maternity waiting homes in rural Rwanda

Provider and client perspectives on the use of maternity waiting homes in rural Rwanda

A simple mathematical model and physical device to estimate a woman-specific probability of skilled birth assistance and associated benefit of maternity waiting home stay

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