The influence of quality maternity waiting homes on utilization of facilities for delivery in rural Zambia
Abstract Background Residential accommodation for expectant mothers adjacent to health facilities, known as maternity waiting homes (MWH), is an intervention designed to improve access to skilled deliveries in low-income countries like Zambia where the maternal mortality ratio is estimated at 398 de...
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doaj-07d3be9f017e4f5e963101f9b354455a2020-11-25T02:31:38ZengBMCReproductive Health1742-47552017-05-0114111010.1186/s12978-017-0328-zThe influence of quality maternity waiting homes on utilization of facilities for delivery in rural ZambiaElizabeth G. Henry0Katherine Semrau1Davidson H. Hamer2Taryn Vian3Mary Nambao4Kaluba Mataka5Nancy A. Scott6Department of Global Health, Boston University School of Public HealthAriadne LabsDepartment of Global Health, Boston University School of Public HealthDepartment of Global Health, Boston University School of Public HealthMinistry of HealthZambia Center for Applied Health Research and Development (ZCAHRD) LimitedDepartment of Global Health, Boston University School of Public HealthAbstract Background Residential accommodation for expectant mothers adjacent to health facilities, known as maternity waiting homes (MWH), is an intervention designed to improve access to skilled deliveries in low-income countries like Zambia where the maternal mortality ratio is estimated at 398 deaths per 100,000 live births. Our study aimed to assess the relationship between MWH quality and the likelihood of facility delivery in Kalomo and Choma Districts in Southern Province, Zambia. Methods We systematically assessed and inventoried the functional capacity of all existing MWH using a quantitative facility survey and photographs of the structures. We calculated a composite score and used multivariate regression to quantify MWH quality and its association with the likelihood of facility delivery using household survey data collected on delivery location in Kalomo and Choma Districts from 2011–2013. Results MWH were generally in poor condition and composite scores varied widely, with a median score of 28.0 and ranging from 12 to 66 out of a possible 75 points. Of the 17,200 total deliveries captured from 2011–2013 in 40 study catchment area facilities, a higher proportion occurred in facilities where there was either a MWH or the health facility provided space for pregnant waiting mothers compared to those with no accommodations (60.7% versus 55.9%, p <0.001). After controlling for confounders including implementation of Saving Mothers Giving Life, a large-scale maternal health systems strengthening program, among women whose catchment area facilities had an MWH, those women with MWHs in their catchment area that were rated medium or high quality had a 95% increase in the odds of facility delivery than those whose catchment area MWHs were of poor quality (OR: 1.95, 95% CI 1.76, 2.16). Conclusions Improving both the availability and the quality of MWH represents a potentially useful strategy to increasing facility delivery in rural Zambia. Trial registration The Zambia Chlorhexidine Application Trial is registered at Clinical Trials.gov (identifier: NCT01241318)http://link.springer.com/article/10.1186/s12978-017-0328-zMaternity waiting homeFacility-based deliveryMaternal healthNewborn healthSkilled birth attendanceZambia |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Elizabeth G. Henry Katherine Semrau Davidson H. Hamer Taryn Vian Mary Nambao Kaluba Mataka Nancy A. Scott |
spellingShingle |
Elizabeth G. Henry Katherine Semrau Davidson H. Hamer Taryn Vian Mary Nambao Kaluba Mataka Nancy A. Scott The influence of quality maternity waiting homes on utilization of facilities for delivery in rural Zambia Reproductive Health Maternity waiting home Facility-based delivery Maternal health Newborn health Skilled birth attendance Zambia |
author_facet |
Elizabeth G. Henry Katherine Semrau Davidson H. Hamer Taryn Vian Mary Nambao Kaluba Mataka Nancy A. Scott |
author_sort |
Elizabeth G. Henry |
title |
The influence of quality maternity waiting homes on utilization of facilities for delivery in rural Zambia |
title_short |
The influence of quality maternity waiting homes on utilization of facilities for delivery in rural Zambia |
title_full |
The influence of quality maternity waiting homes on utilization of facilities for delivery in rural Zambia |
title_fullStr |
The influence of quality maternity waiting homes on utilization of facilities for delivery in rural Zambia |
title_full_unstemmed |
The influence of quality maternity waiting homes on utilization of facilities for delivery in rural Zambia |
title_sort |
influence of quality maternity waiting homes on utilization of facilities for delivery in rural zambia |
publisher |
BMC |
series |
Reproductive Health |
issn |
1742-4755 |
publishDate |
2017-05-01 |
description |
Abstract Background Residential accommodation for expectant mothers adjacent to health facilities, known as maternity waiting homes (MWH), is an intervention designed to improve access to skilled deliveries in low-income countries like Zambia where the maternal mortality ratio is estimated at 398 deaths per 100,000 live births. Our study aimed to assess the relationship between MWH quality and the likelihood of facility delivery in Kalomo and Choma Districts in Southern Province, Zambia. Methods We systematically assessed and inventoried the functional capacity of all existing MWH using a quantitative facility survey and photographs of the structures. We calculated a composite score and used multivariate regression to quantify MWH quality and its association with the likelihood of facility delivery using household survey data collected on delivery location in Kalomo and Choma Districts from 2011–2013. Results MWH were generally in poor condition and composite scores varied widely, with a median score of 28.0 and ranging from 12 to 66 out of a possible 75 points. Of the 17,200 total deliveries captured from 2011–2013 in 40 study catchment area facilities, a higher proportion occurred in facilities where there was either a MWH or the health facility provided space for pregnant waiting mothers compared to those with no accommodations (60.7% versus 55.9%, p <0.001). After controlling for confounders including implementation of Saving Mothers Giving Life, a large-scale maternal health systems strengthening program, among women whose catchment area facilities had an MWH, those women with MWHs in their catchment area that were rated medium or high quality had a 95% increase in the odds of facility delivery than those whose catchment area MWHs were of poor quality (OR: 1.95, 95% CI 1.76, 2.16). Conclusions Improving both the availability and the quality of MWH represents a potentially useful strategy to increasing facility delivery in rural Zambia. Trial registration The Zambia Chlorhexidine Application Trial is registered at Clinical Trials.gov (identifier: NCT01241318) |
topic |
Maternity waiting home Facility-based delivery Maternal health Newborn health Skilled birth attendance Zambia |
url |
http://link.springer.com/article/10.1186/s12978-017-0328-z |
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