Reasons for low utilization of a maternity waiting home in rural Kenya

Mramba, Lazarus K.; Nassir, Faiza; Ondieki, Charles; Kimanga, Davies

doi:10.1016/j.ijgo.2009.08.029

Cited by 51 publications

(87 citation statements)

References 2 publications

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“…From the perspectives of women who used the facility, a lack of privacy, poor toilet and bathing facilities, poor or inadequate kitchen facilities, the non provision of food, and lack of space for women to stay post-partum were considerable barriers to MHW use. [10, 13, 15, 17, 25, 27–30, 36, 37] Overall, MWHs were better used and accepted by women and their families when they provided basic infrastructure and facilities such as those mentioned above [17, 27, 36, 37]. In one MWH in Ethiopia the availability of a hot shower was very popular with women [13].…”

Section: Resultsmentioning

confidence: 99%

“…The type and quality of maternity care services received by women varied. Three studies noted that there were no regular visits by health care providers to the MWH and that referral from the MWH to the facility was not smooth [10, 29, 36]. In other sites, women regularly attended the nearby health facility, or were visited in the MWH by staff from the facility [14, 26, 31].…”

Section: Resultsmentioning

confidence: 99%

“…Community involvement was important to identify cultural factors that affected the use of the MHW; for example, family members, namely the husband or mother-in-law, would not “allow” women to use the MWH or to be away from the household for an extended length of time due to childcare and other household duties [17, 27, 31, 36, 37]. Awareness building efforts were especially important in places where community members had little knowledge of the MWH, which in itself constituted an important barrier to MWH use [17, 28, 36].…”

Section: Resultsmentioning

confidence: 99%

“…Awareness building efforts were especially important in places where community members had little knowledge of the MWH, which in itself constituted an important barrier to MWH use [17, 28, 36]. …”

Section: Resultsmentioning

confidence: 99%

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Understanding the implementation of maternity waiting homes in low- and middle-income countries: a qualitative thematic synthesis

Penn‐Kekana

Pereira

Hussein

et al. 2017

BMC Pregnancy Childbirth

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BackgroundMaternity waiting homes (MWHs) are accommodations located near a health facility where women can stay towards the end of pregnancy and/or after birth to enable timely access to essential childbirth care or care for complications. Although MWHs have been implemented for over four decades, different operational models exist. This secondary thematic +analysis explores factors related to their implementation.MethodsA qualitative thematic analysis was conducted using 29 studies across 17 countries. The papers were identified through an existing Cochrane review and a mapping of the maternal health literature. The Supporting the Use of Research Evidence framework (SURE) guided the thematic analysis to explore the perceptions of various stakeholders and barriers and facilitators for implementation. The influence of contextual factors, the design of the MWHs, and the conditions under which they operated were examined.ResultsKey problems of MWH implementation included challenges in MWH maintenance and utilization by pregnant women. Poor utilization was due to lack of knowledge and acceptance of the MWH among women and communities, long distances to reach the MWH, and culturally inappropriate care. Poor MWH structures were identified by almost all studies as a major barrier, and included poor toilets and kitchens, and a lack of space for family and companions. Facilitators included reduced or removal of costs associated with using a MWH, community involvement in the design and upkeep of the MWHs, activities to raise awareness and acceptance among family and community members, and integrating culturally-appropriate practices into the provision of maternal and newborn care at the MWHs and the health facilities to which they are linked.ConclusionMWHs should not be designed as an isolated intervention but using a health systems perspective, taking account of women and community perspectives, the quality of the MWH structure and the care provided at the health facility. Careful tailoring of the MWH to women’s accommodation, social and dietary needs; low direct and indirect costs; and a functioning health system are key considerations when implementing MWH. Improved and harmonized documentation of implementation experiences would provide a better understanding of the factors that impact on successful implementation.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Understanding the implementation of maternity waiting homes in low- and middle-income countries: a qualitative thematic synthesis

Penn‐Kekana

Pereira

Hussein

et al. 2017

BMC Pregnancy Childbirth

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show abstract

“…A study of a failed intervention in Kenya revealed the majority of women surveyed stated they would need their husband’s approval to use the MWH (Mramba et al, 2010), indicating the importance of family and community support, regardless of whether the intervention was initiated by the community or an external organization. Homes act as a proxy for facility-based births, yet traditional birthing practices may mean that facility-based births are unacceptable due to separation from family and lack of privacy.…”

Section: Literature Reviewmentioning

confidence: 99%

Promoting access: The use of maternity waiting homes to achieve safe motherhood

Lori¹,

Wadsworth²,

Munro³

et al. 2013

Midwifery

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Maternity waiting facilities for improving maternal and neonatal outcome in low-resource countries

Lonkhuijzen

Stekelenburg

Roosmalen

2012

Cochrane Database of Systematic Reviews

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Background A maternity waiting home (MWH) is a facility within easy reach of a hospital or health centre which provides emergency obstetric care (EmOC). Women may stay in the MWH at the end of their pregnancy and await labour. Once labour starts, women move to the health facility so that labour and giving birth can be assisted by a skilled birth attendant. The aim of the MWH is to improve accessibility to skilled care and thus reduce morbidity and mortality for mother and neonate should complications arise. Some studies report a favourable effect on the outcomes for women and their newborns. Others show that utilisation is low and barriers exist. However, these data are limited in their reliability. Objectives To assess the effects of a maternity waiting facility on maternal and perinatal health. Search methods We searched the Cochrane Pregnancy and Childbirth Group’s Trials Register (27 January 2012), CENTRAL (The Cochrane Library 2011, Issue 4 of 4), MEDLINE (1966 to January 2012), EMBASE (1980 to January 2012), CINAHL (1982 to January 2012), African Journals Online (AJOL) (January 2012), POPLINE (January 2012), Dissertation Abstracts (January 2012) and reference lists of retrieved papers. Selection criteria Randomised controlled trials including quasi-randomised and cluster-randomised trials that compared perinatal and maternal outcome in women using a MWH and women who did not. Data collection and analysis There were no randomised controlled trials or cluster-randomised trials identified from the search. Main results There were no randomised controlled trials or cluster-randomised trials identified from the search. Authors’ conclusions There is insufficient evidence to determine the effectiveness of maternity waiting facilities for improving maternal and neonatal outcomes.

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Reasons for low utilization of a maternity waiting home in rural Kenya

Cited by 51 publications

References 2 publications

Understanding the implementation of maternity waiting homes in low- and middle-income countries: a qualitative thematic synthesis

Understanding the implementation of maternity waiting homes in low- and middle-income countries: a qualitative thematic synthesis

Promoting access: The use of maternity waiting homes to achieve safe motherhood

Maternity waiting facilities for improving maternal and neonatal outcome in low-resource countries

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