The effectiveness of maternity waiting homes in reducing perinatal mortality: a case–control study in Ethiopia

Zuanna, Teresa Dalla; Fonzo, Marco; Resti, C; Tsegaye, Ademe; Azzimonti, Gaetano; Manenti, Fabio; Putoto, Giovanni; Bertoncello, Chiara

doi:10.1136/bmjgh-2020-004140

Cited by 9 publications

(8 citation statements)

References 21 publications

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“…Women living in cities are on average better educated, belong to wealthier families, and have easier access to medical and social care services than women living in rural areas. 11,30 Interestingly, in our sample, the difference in access to ANC between HIV-positive and HIV-negative women changes when stratifying the two populations on the basis of the area of origin. In the HIV-negative population, women who live in cities and have attended at least one ANC visit are twice as likely as women from rural areas (36.2% vs. 18.8%, P < 0.001).…”

Section: Discussionmentioning

confidence: 81%

“…In line with the definition proposed at the World Health Organization (WHO) audit and review of stillbirths and neonatal deaths Making every baby count , stillbirth was defined as a baby born with no signs of life after 28 weeks of gestation or weighing more than 1000 g. In more detail, both macerated stillbirth (dead before the onset of labor and presenting degenerative changes) and fresh stillbirth (dead during labor or delivery) were considered. Early neonatal mortality was defined as a baby born alive but dead within 7 days 11,12 …”

Section: Methodsmentioning

confidence: 99%

“…Early neonatal mortality was defined as a baby born alive but dead within 7 days. 11,12 On the other hand, we considered as 'controls' mothers giving birth in the same hospital, whose childbirth resulted in a baby alive at 7 days (or until hospital discharge). For each case, we included two controls, more specifically the two mothers who followed each case on the delivery registry.…”

Section: Me Thodsmentioning

confidence: 99%

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The HIV paradox: Perinatal mortality is lower in HIV‐positive mothers—A field case–control study in Ethiopia

Fonzo

Zuanna

Amoruso

et al. 2023

Intl J Gynecology & Obste

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Objective Sub‐Saharan African countries have the highest perinatal mortality rates. Although HIV is a risk factor for perinatal death, antioretroviral therapy (ART) programs have been associated with better outcomes. We aimed to investigate how maternal HIV affects perinatal mortality. Methods The authors performed a nested case–control study at Saint Luke Hospital, Wolisso, Ethiopia. Data on sociodemographic characteristics, current maternal conditions, obstetric history, and antenatal care (ANC) services utilization were collected. The association between perinatal mortality and HIV was assessed with logistic regression adjusting for potential confounders. Results A total of 3525 birthing women were enrolled, including 1175 cases and 2350 controls. Perinatal mortality was lower among HIV‐positive women (18.3% vs. 33.6%, P = 0.007). Crude analysis showed a protective effect of HIV (odds ratio, 0.442 [95% confidence interval, 0.241–0.810]), which remained after adjustment (adjusted odds ratio, 0.483 [95% confidence interval, 0.246–0.947]). Among HIV‐negative women, access to ANC for women from rural areas was almost half (18.8% vs. 36.2%; P < 0.001), whereas in HIV‐positive women, no differences were noted (P = 0.795). Conclusion Among HIV‐positive mothers, perinatal mortality was halved and differences in access to ANC services by area were eliminated. These data highlight the benefits of integrating ANC and HIV services in promoting access to the health care system, reducing inequalities and improving neonatal mortality.

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Section: Discussionmentioning

confidence: 81%

Section: Methodsmentioning

confidence: 99%

Section: Me Thodsmentioning

confidence: 99%

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The HIV paradox: Perinatal mortality is lower in HIV‐positive mothers—A field case–control study in Ethiopia

Fonzo

Zuanna

Amoruso

et al. 2023

Intl J Gynecology & Obste

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“…Considering the gap, Ethiopia has established maternity waiting rooms (MWRs), which serve as a waiting area until labor is initiated. The major triggering factors for the establishment of MWRs, among others, were to address barriers to reach to care due to distance, unfavorable seasonal climate, and lack of infrastructure (transportation and effective referral communication) [ 61 ]. However, in the Ethiopian context, the utilization of MWRs is affected by the proximity of the mother to a health facility, availability of companion support, and poor awareness about the service [ 62 , 63 ].…”

Section: Discussionmentioning

confidence: 99%

Area of focus to handle delays related to maternal death in Ethiopia

et al. 2022

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Background Maternal delay factors, together with medical factors, have a substantial role in determining maternity outcomes. Although several studies were conducted on delay factors that contribute to maternal death in Ethiopia, the studies were mostly focused either on an individual or at a provincial level factor with a limited number of study participants. In response to this gap, this study is aimed at exploring the magnitude and factors related to delay factors that contribute to maternal death in Ethiopia. Methods The study used maternal death surveillance data collected from different regions of Ethiopia, compiled between 2013 and 2021. A total of 4530 maternal deaths were reviewed during the study period. A Multilevel multinomial logistic regression model was applied to examine factors associated with delays related to maternal death. An adjusted relative risk ratio with a 95% confidence interval was stated and variables with p-values less than 0.05 were declared as significant predictors of maternal delay. Result Delay three (delay in receiving adequate and appropriate care once reached a health facility) has contributed to 36.3% of maternal deaths followed by delay one (delay in deciding to seek care when experiencing an obstetric emergency) and delay two (delay in reaching to an appropriate obstetric facility) where each of them contributed to 36.1% and 27.6% of maternal deaths respectively. In the multivariate multilevel multinomial model, maternal age, education status, and place of death were among the individual level factors associated with both delay two and delay three. Conversely, marital status and ANC follow-up were associated with delay two alone, while the timing of maternal death was associated with delay three. Residence and type of facility were provincial-level factors linked with both delay two and delay three, while the type of region was related to delay three of maternal death. Conclusion Both delay one and three have a major contribution to maternal death in Ethiopia. Individual and provincial level factors played an important role in determining delays related to maternal death. Therefore, it is crucial to account for measures that provide emphasis on the area of raising awareness on the utilization of Antenatal care (ANC) service, improving facility readiness to handle obstetrics emergencies, and narrowing down inequality among regions in service provision.

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“…The first MWHs in Ethiopia were established as early as 1973, at Attat Our Lady of Lourdes Catholic Primary Hospital (3). The MWHs are important to improve institutional delivery and facilitate reduction in maternal and neonatal mortality and improve maternal and neonatal outcomes by fast-tracking women to emergency care (3)(4)(5).…”

Section: Introductionmentioning

confidence: 99%

Knowledge and attitude of women towards maternity waiting homes and associated factors among women who gave birth in the last twelve months in Dega Damot district, northwest Ethiopia

Anteneh

Solomon

Tamiru

et al. 2023

Front. Glob. Womens Health

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BackgroundMaternal waiting homes have been identified as one strategy to reduce maternal and perinatal mortality by bringing women living in hard-to-reach areas closer to a health facility that provides emergency obstetric care. Even if utilization of maternal waiting homes is repeatedly assessed, there is a scarcity of evidence in Ethiopia regarding women's knowledge and attitude towards maternal waiting homes.ObjectiveThis study aimed to assess women's knowledge and attitude towards maternity waiting homes and associated factors among women who gave birth in the last twelve months in northwest Ethiopia.MethodsA community-based cross-sectional study was conducted from January 1st to February 30th, 2021. A total of 872 participants were selected by using a stratified cluster sampling technique. Data were collected by face-to-face interviews using a structured, pretested, and interviewer-administered questionnaire. Data were entered into EPI data version 4.6 and analysis was done through SPSS version 25. The multivariable logistic regression model was fitted and the level of significance was declared at a p-value of ≤0.05.ResultWomen's adequate knowledge and positive attitude towards maternal waiting homes were 67.3% (95% CI: 64–70) and 73% (95% CI: 70–76), respectively. Had antenatal care visit, the shortest distance to reach the nearby health facility, had history of maternal waiting homes utilization, always involved in health care decision, and sometimes involved in health care decisions were significantly associated with women's knowledge regarding maternal waiting homes. Moreover, secondary and above educational level of women, short distance to reach the nearby health facility and had antenatal care visit were significantly associated with women's attitude towards maternity waiting homes.ConclusionAbout two-third of women had adequate knowledge and nearly three-fourth of women had a positive attitude towards maternity waiting homes. It is better to improve the accessibility and utilization of maternal health services Furthermore, it is better to promote women's decision making power and create motivation to have better academic achievement of women.

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The effectiveness of maternity waiting homes in reducing perinatal mortality: a case–control study in Ethiopia

Cited by 9 publications

References 21 publications

The HIV paradox: Perinatal mortality is lower in HIV‐positive mothers—A field case–control study in Ethiopia

The HIV paradox: Perinatal mortality is lower in HIV‐positive mothers—A field case–control study in Ethiopia

Area of focus to handle delays related to maternal death in Ethiopia

Knowledge and attitude of women towards maternity waiting homes and associated factors among women who gave birth in the last twelve months in Dega Damot district, northwest Ethiopia

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