scholarly journals Out-of-Pocket Expenditures for Delivery for Maternity Waiting Home Users and Non-users in Rural Zambia

2021 ◽  
Author(s):  
Constance P. Fontanet ◽  
Jeanette L. Kaiser ◽  
Rachel M. Fong ◽  
Thandiwe Ngoma ◽  
Jody R. Lori ◽  
...  
Keyword(s):  
Rural Health ◽  
Health Facility ◽  
Obstetric Care ◽  
Maternity Waiting Homes ◽  
Significant Difference ◽  
Maternity Waiting Home ◽  
Us Dollar ◽  
Rural Zambia ◽  
Home Users ◽  
Improve Access

Background: Utilizing maternity waiting homes (MWHs) is a strategy to improve access to skilled obstetric care in rural Zambia. However, out-of-pocket (OOP) expenses remain a barrier for many women. We assessed delivery-related expenditure for women who used MWHs and those who did not who delivered at a rural health facility. Methods: During the endline of an impact evaluation for an MWH intervention, household surveys (n = 826) were conducted with women who delivered a baby in the previous 13 months at a rural health facility and lived >10 km from a health facility in seven districts of rural Zambia. We captured the amount women reported spending on delivery. We compared OOP spending between women who used MWHs and those who did not. Amounts were converted from Zambian kwacha (ZMW) to US dollar (USD). Results: After controlling for confounders, there was no significant difference in delivery-related expenditure between women who used MWHs (US$40.01) and those who did not (US$36.66) (P=.06). Both groups reported baby clothes as the largest expenditure. MWH users reported spending slightly more on accommodation compared to those did not use MWHs, but this difference represents only a fraction of total costs associated with delivery. Conclusion: Findings suggest that for women coming from far away, utilizing MWHs while awaiting delivery is not costlier overall than for women who deliver at a health facility but do not utilize a MWH.

scholarly journals Utilization of Maternity Waiting Home (MWH) to Improve Access to Health Services: Systematic Literature Review

2020 ◽  
Vol 7 (3) ◽  
pp. 368-375
Author(s):  
Nuraina Nuraina
Keyword(s):  
Rural Areas ◽  
Urban Areas ◽  
Health Workers ◽  
Emergency Obstetric Care ◽  
Obstetric Care ◽  
Access To Health Services ◽  
Care Services ◽  
Access To Health ◽  
Maternity Waiting Home ◽  
Improve Access

Maternity waiting home (MWH) is a home built in the compound or near to health facilities that provides standard medical and emergency obstetric care services. MWH is considered to be a key strategy to "bridge the geographical gap" in obstetric care between rural areas with poor access to equipped facilities, and urban areas where the services are available. This study aimed to systematically review the utilization of MWH to improve access to health service. The method of finding articles in this study was in the period 2014 to 2018, free full text, human species, and scholarly journals which were then identified using an electronic database from Pubmed, Proquest and Onesearch. Three articles were carried out with thematic analysis to identify the main points. Factors associated with the utilization of MWH included (1) Distance; (2) Complication during pregnancy; and (3) Income. Barrier in the utilization of MWH were (1) Inadequate number of room and postpartum bed; (2) Lack of water and sanitation facilities; and (3) Unavailable electricity. Partnership between health workers in rural facilities, stronger role of stakeholders, and a broader health system, were expected to increase the utilization of MWH.

scholarly journals Preconception Care among Pregnant Women in an Urban and a Rural Health Facility in Kenya: A Quantitative Study

2020 ◽  
Vol 17 (20) ◽  
pp. 7430
Author(s):  
Joan Okemo ◽  
Marleen Temmerman ◽  
Mukaindo Mwaniki ◽  
Dorothy Kamya
Keyword(s):  
Pregnant Women ◽  
Rural Health ◽  
Health Facility ◽  
Preconception Care ◽  
University Hospital ◽  
Cross Sectional ◽  
Mother And Child Health ◽  
Significant Difference ◽  
Mother And Child ◽  
Low Levels

Preconception care (PCC) aims to improve maternal and fetal health outcomes, however, its utilization remains low in developing countries. This pilot study assesses the level and determinants of PCC in an urban and a rural health facility in Kenya. Unselected pregnant women were recruited consecutively at the Mother and Child Health (MCH) clinics in Aga Khan University Hospital, Nairobi (AKUH, N-urban) and Maragua Level Four Hospital (MLFH-rural). The utilization of PCC was defined as contact with any health care provider before current pregnancy and addressing pregnancy planning and preparation. A cross-sectional approach was employed and data were analyzed using SPSS version 22. 194 participants were recruited (97 in each setting) of whom, 25.8% received PCC. Age, marital status, education, parity and occupation were significant determinants of PCC uptake. There was also a significant difference in PCC uptake between the rural (16.5%) and urban (35.1%) participants (p < 0.01), OR of 0.3 (0.19–0.72, 95% CI). The low level of PCC in Kenya revealed in this study is consistent with the low levels globally. However, this study was not powered to allow firm conclusions and analyze the true effects of PCC determinants. Therefore, further research in the field is recommended in order to inform strategies for increasing PCC utilization and awareness in Kenya.

scholarly journals Effectiveness of maternity waiting homes in increasing utilization of facility-based delivery: A systematic review

2021 ◽  
Vol 10 (3) ◽  
pp. 529
Author(s):  
Absa Secka ◽  
Samsriyaningsih Handayani
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Facility Delivery ◽  
Inclusion Criteria ◽  
Skilled Delivery ◽  
Remote Areas ◽  
Maternity Waiting Homes ◽  
Maternity Waiting Home ◽  
Improve Access

To reduce the second delay contributing to maternal mortality, maternity waiting homes have been recommended for implementation especially in remote areas to help improve access to facility-based skilled delivery. Evidence of its effectiveness, however, is limited. This systematic review, therefore, aims to assess the effectiveness of the Maternity waiting home strategy in increasing utilization of facility delivery. Search for relevant articles was conducted on PubMed, Scopus, Google Scholar, Ebscohost, and Science Direct from database inception to March 30, 2021. Two reviewers independently screened the articles and assessed the quality of the studies. The identified maternity waiting home interventions and their effectiveness in improving facility-based delivery uptake were narratively synthesized and reported following the preferred reporting items for systematic reviews and meta-analysis reporting guidelines. The search yielded 670 articles of which five studies fulfilled the inclusion criteria. The three of five studies revealed that there is a significant association between Maternity waiting home use and utilization of facility-based delivery. The quality of the Maternity waiting homes significantly improved facility-based delivery uptake. Maternity Waiting Homes appear to be promising in decreasing barriers to skilled delivery attendance however the quality of evidence is low. More interventional studies of robust design are needed to clearly demonstrate its effectiveness.

scholarly journals Barreras en la atención de la morbilidad materna en Yaxkukul, Yucatán, México

2019 ◽  
pp. 28-37
Author(s):  
Elsa RODRÍGUEZ-ANGULO ◽  
Marita SOLÍS-RIVERO ◽  
Ricardo OJEDA-RODRÍGUEZ ◽  
Guadalupe ANDUEZA-PECH
Keyword(s):  
Pregnant Women ◽  
Rural Health ◽  
Obstetric Care ◽  
Cross Sectional ◽  
Obstetric Emergency ◽  
A Value ◽  
Rural Health Center ◽  
Quality Of Obstetric Care ◽  
Three Delays

Objectives. Identify the barriers that cause delays in the route of obstetric care in pregnant women of Yaxkukul, Yucatán, from January 2016 to May 2018. Methodology. Observational, descriptive, cross-sectional and retrospective study. Pregnant women who attended prenatal control at the rural health center of Yaxkukul were interviewed and reviewed their clinical record. Sociodemographic characteristics, prenatal control were studied and the critical route of obstetric care was described, under the model of the three delays. Percentages, measures of central tendency and dispersion were calculated; as well as square chi to look for association between delays and maternal morbidity. A 95% confidence level and a value of p <0.05 were used. Contribution. The present study contributes to the prevention of maternal and perinatal mortality. Knowing the barriers that cause delays in care can identify deficiencies in the obstetric emergency protocol established in rural health units, to improve the quality of obstetric care.

Exploring the experience and challenges of maternity waiting homes in Jimma, southwest Ethiopia

2021 ◽  
pp. 1-11
Author(s):  
Woubishet Girma ◽  
Dessalegn Tamiru ◽  
Mirkuzie Woldie ◽  
Ayantu Kebede ◽  
Zewdie Birhanu ◽  
...  
Keyword(s):  
Focus Group ◽  
Rural Areas ◽  
Healthcare Providers ◽  
Computer Software ◽  
Obstetric Care ◽  
Focus Group Discussions ◽  
Group Discussions ◽  
Transportation Services ◽  
Care Access ◽  
Maternity Waiting Homes

Background Establishing maternity waiting homes is a key strategy to address the geographic barrier to obstetric care access among women living in rural areas. In Ethiopia, maternity waiting homes have been in use for several years, with a sharp increase in the number of such facilities recently. However, there is little empirical evidence detailing the experiences and challenges faced by women during the implementation of this initiative in Ethiopia. Methods This study used a multiple case study design with qualitative data collection methods, and was conducted from October to November 2016. Data were collected using focus group discussions, in-depth interviews and direct observation of each maternity waiting home. All interviews and focus group discussions were recorded using a digital voice recorder. Data were transcribed and translated into English. The coding process and formation of thematic structure was assisted by Atlas ti7.5 computer software. Results The participants reported that they were satisfied and comfortable with the services at the maternity waiting homes, as were their husbands and community leaders. Facility, social and environmental challenges were identified as common barriers to the utilisation of maternity waiting homes by stakeholders at different levels. Healthcare providers reported common challenges at maternity waiting homes include a lack of basic utilities (water and electric supply), and overcrowding because of a shortage of space and lack of medical supplies. Some women reported that poor transportation services and the distance to facilities hindered the utilisation of maternity waiting homes. Conclusions There are social and facility challenges related to the use of maternity waiting homes in Ethiopia. Policymakers and health managers should work with relevant sectors to mitigate the effect of facility, social and environmental barriers and maximise the use of maternity waiting homes.

High prevalence of cesarean section delivery among health facilities delivered mothers in Bahir Dar city, Amhara region, Ethiopia. A comparative study

2019 ◽  
Author(s):  
Meseret Bantigegn Melesse ◽  
Alehegn Bishaw Geremew ◽  
Solomon Mekonnen Abebe
Keyword(s):  
Cesarean Section ◽  
Health Facility ◽  
Health Facilities ◽  
Public Facility ◽  
Bahir Dar ◽  
Amhara Region ◽  
Public And Private ◽  
Cesarean Section Delivery ◽  
Private Health Facility ◽  
Significant Difference

Abstract Background Cesarean section delivery prevalence rate has been in an alarming increase worldwide each year; there are large disparities of CS proportion among women who give birth at a public and private health facility. However, there is a lack of evidence regarding the underlying factors and the proportion of CS delivery in public and private health facilities. Therefore this study aimed to asses and compare the prevalence of CS delivery and associated factors among public and private health facilities delivered mother in Bahir Dar city, Amhara region, Ethiopia, Methods An institution-based comparative cross-sectional study design was conducted from March1-April 15, 2019 health facility in Bahir Dar city. Study participants 724(362 for each public and private facility) were recruited through a systematic random sampling technique. Structured interview administered questionnaires and chart review checklist were used to collect data. The data were entered with Epi info version 7.2 and analyzed using SPSS version 23.0 software. A binary logistic regression model was fitted and an adjusted odds ration with 95% CI was used to determine the presence and strength of association between independent variables and cesarean section delivery. Results The response rate was 98.3% and 97.2% for public and private health facilities respectively. The prevalence of CS in private health facilities was198 (56.3%) (95%CI: 50.9, 61.4) and 98 (27.5%) (95%CI: 22.8, 32.2) was in public health facilities. Overall prevalence of CS delivery was 296(41.8%) (95% CI: 38.4, 45.5). Breech presentation (AOR=3.64; 95%CI (1.49, 8.89), urban residence (AOR=6.54; 95%CI (2.59, 16.48) and being referred (AOR=2.44; 95%CI (1.46, 4.08)were variables significantly associated with CS among public facility whereas age between 15-24 (AOR=0.20, 95% CI; 0.07,0.52),governmental employee (AOR=2.28;95%CI (1.39,3.75),self-employed (AOR=3.73;95%CI(1.62,8.59),Para one(AOR=6.79;95%CI(2.02,22.79) Para two (AOR=3.88;95% CI(1.15,13.08), and wealth index being highest level of wealth asset AOR=5.39; 95%CI (1.08, 26.8) in private health facility: Conclusion and recommendation We concluded that there is a statistically significant difference in the prevalence of CS delivery in public and private health facilities. Therefore, there should be a mechanism for a medical audit of labor management.

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