If we build it, will they come? Results of a quasi-experimental study assessing the impact of maternity waiting homes on facility-based childbirth and maternity care in Zambia

IntroductionMaternity waiting homes (MWHs) aim to increase access to maternity and emergency obstetric care by allowing women to stay near a health centre before delivery. An improved MWH model was developed with community input and included infrastructure, policies and linkages to health centres. We hypothesised this MWH model would increase health facility delivery among remote-living women in Zambia.MethodsWe conducted a quasi-experimental study at 40 rural health centres (RHC) that offer basic emergency obstetric care and had no recent stockouts of oxytocin or magnesium sulfate, located within 2 hours of a referral hospital. Intervention clusters (n=20) received an improved MWH model. Control clusters (n=20) implemented standard of care. Clusters were assigned to study arm using a matched-pair randomisation procedure (n=20) or non-randomly with matching criteria (n=20). We interviewed repeated cross-sectional random samples of women in villages 10+ kilometres from their RHC. The primary outcome was facility delivery; secondary outcomes included postnatal care utilisation, counselling, services received and expenditures. Intention-to-treat analysis was conducted. Generalised estimating equations were used to estimate ORs.ResultsWe interviewed 2381 women at baseline (March 2016) and 2330 at endline (October 2018). The improved MWH model was associated with increased odds of facility delivery (OR 1.60 (95% CI: 1.13 to 2.27); p<0.001) and MWH utilisation (OR 2.44 (1.62 to 3.67); p<0.001). The intervention was also associated with increased odds of postnatal attendance (OR 1.55 (1.10 to 2.19); p<0.001); counselling for family planning (OR 1.48 (1.15 to 1.91); p=0.002), breast feeding (OR 1.51 (1.20 to 1.90); p<0.001), and kangaroo care (OR 1.44 (1.15, 1.79); p=0.001); and caesarean section (OR 1.71 (1.16 to 2.54); p=0.007). No differences were observed in household expenditures for delivery.ConclusionMWHs near well-equipped RHCs increased access to facility delivery, encouraged use of facilities with emergency care capacity, and improved exposure to counselling. MWHs can be useful in the effort to increase delivery at advanced facilities in areas where substantial numbers of women live remotely.Trial registration numberNCT02620436.

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The impact of a multi-level maternal health programme on facility delivery and capacity for emergency obstetric care in Zambia

Global Public Health ◽

10.1080/17441692.2017.1385824 ◽

2017 ◽

Vol 13 (10) ◽

pp. 1481-1494 ◽

Cited By ~ 5

Author(s):

Elizabeth G. Henry ◽

Donald M. Thea ◽

Davidson H. Hamer ◽

William DeJong ◽

Kebby Musokotwane ◽

...

Keyword(s):

Maternal Health ◽

Emergency Obstetric Care ◽

Obstetric Care ◽

Facility Delivery ◽

Multi Level ◽

The Impact ◽

Health Programme

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‘The clock keeps ticking’ – the role of a community-based intervention in reducing delays in seeking emergency obstetric care in rural Bangladesh: a quasi-experimental study

Public Health ◽

10.1016/j.puhe.2014.01.009 ◽

2014 ◽

Vol 128 (4) ◽

pp. 332-340 ◽

Cited By ~ 5

Author(s):

M. Banu ◽

M. Akter ◽

K. Begum ◽

R.H. Choudhury ◽

H.E. Nasreen

Keyword(s):

Experimental Study ◽

Emergency Obstetric Care ◽

Obstetric Care ◽

Community Based ◽

Rural Bangladesh ◽

Quasi Experimental

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Impact of maternity waiting homes on facility delivery among remote households in Zambia: protocol for a quasiexperimental, mixed-methods study

BMJ Open ◽

10.1136/bmjopen-2018-022224 ◽

2018 ◽

Vol 8 (8) ◽

pp. e022224 ◽

Cited By ~ 7

Author(s):

Nancy A Scott ◽

Jeanette L Kaiser ◽

Taryn Vian ◽

Rachael Bonawitz ◽

Rachel M Fong ◽

...

Keyword(s):

Mixed Methods ◽

Health Facility ◽

Rural Areas ◽

Household Survey ◽

Facility Delivery ◽

Matched Pair ◽

Control Group ◽

Open Access Journals ◽

Maternity Waiting Homes ◽

The Impact

IntroductionMaternity waiting homes (MWHs) aim to improve access to facility delivery in rural areas. However, there is limited rigorous evidence of their effectiveness. Using formative research, we developed an MWH intervention model with three components: infrastructure, management and linkage to services. This protocol describes a study to measure the impact of the MWH model on facility delivery among women living farthest (≥10 km) from their designated health facility in rural Zambia. This study will generate key new evidence to inform decision-making for MWH policy in Zambia and globally.Methods and analysisWe are conducting a mixed-methods quasiexperimental impact evaluation of the MWH model using a controlled before-and-after design in 40 health facility clusters. Clusters were assigned to the intervention or control group using two methods: 20 clusters were randomly assigned using a matched-pair design; the other 20 were assigned without randomisation due to local political constraints. Overall, 20 study clusters receive the MWH model intervention while 20 control clusters continue to implement the ‘standard of care’ for waiting mothers. We recruit a repeated cross section of 2400 randomly sampled recently delivered women at baseline (2016) and endline (2018); all participants are administered a household survey and a 10% subsample also participates in an in-depth interview. We will calculate descriptive statistics and adjusted ORs; qualitative data will be analysed using content analysis. The primary outcome is the probability of delivery at a health facility; secondary outcomes include utilisation of MWHs and maternal and neonatal health outcomes.Ethics and disseminationEthical approvals were obtained from the Boston University Institutional Review Board (IRB), University of Michigan IRB (deidentified data only) and the ERES Converge IRB in Zambia. Written informed consent is obtained prior to data collection. Results will be disseminated to key stakeholders in Zambia, then through open-access journals, websites and international conferences.Trial registration numberNCT02620436; Pre-results.

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Increasing facility delivery through maternity waiting homes for women living farthest from a health facility in rural Zambia: a quasi‐experimental study

BJOG An International Journal of Obstetrics & Gynaecology ◽

10.1111/1471-0528.16755 ◽

2021 ◽

Author(s):

Jody R. Lori ◽

Michelle L. Munro‐Kramer ◽

Haiyin Liu ◽

Kathleen L. McGlasson ◽

Xingyu Zhang ◽

...

Keyword(s):

Experimental Study ◽

Health Facility ◽

Facility Delivery ◽

Maternity Waiting Homes ◽

Quasi Experimental ◽

Rural Zambia

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Protocol for a quasi-experimental study examining the effect of a ball skills intervention on four domains of preschooler development

Primary Health Care Research & Development ◽

10.1017/s1463423621000645 ◽

2021 ◽

Vol 22 ◽

Author(s):

Hua Wu ◽

Wichai Eungpinichpong ◽

Hui Ruan ◽

Xinding Zhang ◽

Sansan Wang ◽

...

Keyword(s):

Experimental Study ◽

Motor Development ◽

Self Regulation ◽

Ecological Factors ◽

Pilot Project ◽

Background Information ◽

Factors Affecting ◽

Quasi Experimental ◽

The Impact ◽

Ball Skills

Abstract Background: Preschooler inactivity and insufficient motor development have serious long-term consequences. The Chinese Ministry of Education launched a nationwide football-focused pilot project aimed at kindergartens in 2019 and issued the policy “Notice on the Establishment of National Football Kindergartens” in 2020. However, the impact of fundamental movement skills (FMS) interventions on other aspects of child development is unclear. Aim: This study will evaluate the effects of ball skills physical education projects on the development of Chinese preschoolers’ physical, motor, cognitive, and social competencies and examine the influencing factors. Method: This is a quasi-experimental study evaluating how well the “Hello Sunshine” curriculum project promotes children’s development over 10 weeks. The trial will be conducted from September 2021 to November 2021 in 12 classes from 3 kindergartens with a total of 249 children aged 4 to 6 years in Haikou, China. Pre- and posttest analyses will include tests on participants’ physical fitness, FMS, cognitive self-regulation, and emotional competence. Participants’ background information will be collected through questionnaires answered by parents and teachers. The intervention will focus on game-based basic ball skills. Findings: If this intervention provides evidence that these skills improve children’s multidimensional development, it will support the promotion of similar programs in China. We will also outline the social-ecological factors affecting the intervention’s results, providing further information for improving pedagogical methods related to preschool ball skills.

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TO STUDY THE IMPACT OF UNILATERAL BREAST MASSAGE ON MILK VOLUME AMONG POSTNATAL MOTHERS - A QUASI-EXPERIMENTAL STUDY

Indian Journal of Child Health ◽

10.32677/ijch.2018.v05.i12.006 ◽

2018 ◽

Vol 5 (12) ◽

pp. 731-734

Author(s):

Santhosh Kumar Kraleti . ◽

Swapna Lingaldinna . ◽

Sravani Kalvala . ◽

Sadiqua Anjum . ◽

Himabindu Singh .

Keyword(s):

Experimental Study ◽

Milk Volume ◽

Postnatal Mothers ◽

Quasi Experimental ◽

The Impact

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The Impact of Primary Health Care on Tuberculosis: A Quasi-Experimental Study Based on a Nationwide Cohort of 7.3 Million Brazilians

SSRN Electronic Journal ◽

10.2139/ssrn.3861558 ◽

2021 ◽

Author(s):

Gabriela dos Santos de Jesus ◽

Julia Moreira Pescarini ◽

Andréa Silva ◽

Ana Wieczorek Torrens ◽

Elzo Pereira Pinto Júnior ◽

...

Keyword(s):

Health Care ◽

Experimental Study ◽

Primary Health Care ◽

Primary Health ◽

Quasi Experimental ◽

The Impact

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Analysis of the Perception of Students about Biometric Identification

International Journal of Web-Based Learning and Teaching Technologies ◽

10.4018/ijwltt.2015070101 ◽

2015 ◽

Vol 10 (3) ◽

pp. 1-18 ◽

Cited By ~ 1

Author(s):

Francisco D. Guillén-Gámez ◽

Iván García-Magariño ◽

Sonia J. Romero

Keyword(s):

Experimental Study ◽

The Other ◽

Biometric Identification ◽

Control Mechanisms ◽

Biometric Authentication ◽

Ethical Aspects ◽

Virtual Classrooms ◽

Quasi Experimental ◽

Teaching Learning ◽

The Impact

Currently, there is a demand within distance education of control mechanisms for verifying the identity of students when conducting activities within virtual classrooms. Biometric authentication is one of the tools to meet this demand and prevent fraud. In this line of research, the present work is aimed at analyzing the perceptions of a group of distance students on the impact on the teaching-learning process of a technology of biometric authentication called Smowl. To meet this objective the authors design a quasi-experimental study with two groups of 50 students, one using Smowl technology and the other not. The results show a comparison of the perceptions of both groups, finding that students who have used Smowl are more favorable towards the use of such tools, except in matters relating to the impact on academic performance and ethical aspects of its use, in which no significant differences were found.

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