Benefits, barriers and enablers of maternity waiting homes utilization in Ethiopia: an integrative review of national implementation experience to date

Abstract

Background Though Ethiopia has expanded Maternity Waiting Homes (MWHs) to reduce maternal and perinatal mortality, the utilization rate is low. To maximize the use of MWH, policymakers must be aware of the barriers and benefits of using MWH. This review aimed to describe the evidence on the barriers and benefits to access and use of MWHs in Ethiopia. Methods Data were sourced from PubMed, Google Scholars and Dimensions. Thirty-one studies were identified as the best evidence for inclusion in this review. We adopted an integrative review process based on the five-stage process proposed by Whittemore and Knafl. Results The key themes identified were the benefits, barriers and enablers of MWH utilization with 10 sub-themes. The themes about benefits of MWHs were lower incidence rate of perinatal death and complications, the low incidence rate of maternal complications and death, and good access to maternal health care. The themes associated with barriers to staying at MWH were distance, transportation, financial costs (higher out-of-pocket payments), the physical aspects of MWHs, cultural constraints and lack of awareness regarding MWHs, women’s perceptions of the quality of care at MWHs, and poor provider interaction to women staying at MWH. Enablers to pregnant women to stay at MWHs were availability of MWHs which are attached with obstetric services with quality and compassionate care. Conclusion This study synthesized research evidence on MWH implementation, aiming to identify benefits, barriers, and enablers for MWH implementation in Ethiopia. Despite the limited and variable evidence, the implementation of the MWH strategy is an appropriate strategy to improve access to skilled birth attendance in rural Ethiopia.

A phenomenological qualitative study of male-partners perspectives of maternity waiting homes in rural Ethiopia

“…In some MWHs, shortages of medical supplies and water were challenges to service provisions. Similarly, other studies revealed that costs related to medical supplies during MWH stay and poor access to clean water are challenges to using MWHs [ 8 , 26 ]. Even though MWH services are free of charge, the lack of basic facilities, including clean water and medical supplies, might discourage women's access to MWHs.…”

Key Success Factors in Maternity Waiting Home Implementation: A Qualitative Study in Rural Indonesia

“…46 Community support is also necessary for implementing MHWs. 17,21,23 The limitation of this study is that it is a qualitative study that was only conducted in 1 district. The research method used is limited to FGDs with several stakeholders.…”

“…The bene ts of MHWs are reduced maternal mortality rates, fewer complications, and better access to maternal health services and information. 23 Theme II. Efforts to increase the implementation of MWHs by stakeholders…”

Effectiveness of couple-based health education on utilization of maternity waiting homes among pregnant women in rural Ethiopia: A study protocol for cluster-randomized trial

“…This suggests that integrating male partners in women's health could enhance the use of MWHs and other maternal health services. Lack of knowledge of MWHs, opinions of the services as being of low quality, poor providers interactions with MWH users, staffing deficit, and home tasks were among the obstacles to MWHs [ 8 , 12 , 13 ].…”