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Increasing facility delivery through maternity waiting homes for women living far from a health facility in rural Zambia: a quasi-experimental study
Journal article   Open access   Peer reviewed

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

J. R. Lori, M. L. Munro-Kramer, H. Liu, K. L. McGlasson, X. Zhang, H. Lee, T. Ngoma, J. L. Kaiser, M. Bwalya, G. Musonda, …
BJOG : an international journal of obstetrics and gynaecology, v 128(11), pp 1804-1812
Oct 2021
PMID: 33993600
url
https://doi.org/10.1111/1471-0528.16755View
Published, Version of Record (VoR) Open

Abstract

Life Sciences & Biomedicine Obstetrics & Gynecology Science & Technology
Objective To report on the effectiveness of a standardised core Maternity Waiting Home (MWH) model to increase facility deliveries among women living >10 km from a health facility. Design Quasi-experimental design with partial randomisation at the cluster level. Setting Seven rural districts in Zambia. Population Women delivering at 40 health facilities between June 2016 and August 2018. Methods Twenty intervention and 20 comparison sites were used to test whether MWHs increased facility delivery for women living in rural Zambia. Difference-in-differences (DID) methodology was used to examine the effectiveness of the core MWH model on our identified outcomes. Main outcome measures Differences in the change from baseline to study period in the percentage of women living >10 km from a health facility who: (1) delivered at the health facility, (2) attended a postnatal care (PNC) visit and (3) were referred to a higher-level health facility between intervention and comparison group. Results We detected a significant difference in the percentage of deliveries at intervention facilities with the core MWH model for all women living >10 km away (DID 4.2%, 95% CI 0.6-7.6, P = 0.03), adolescent women (<18 years) living >10 km away (DID 18.1%, 95% CI 6.3-29.8, P = 0.002) and primigravida women living >10 km away (DID 9.3%, 95% CI 2.4-16.4, P = 0.01) and for women attending the first PNC visit (DID 17.8%, 95% CI 7.7-28, P < 0.001). Conclusion The core MWH model was successful in increasing rates of facility delivery for women living >10 km from a healthcare facility, including adolescent women and primigravidas and attendance at the first PNC visit. Tweetable abstract A core MWH model increased facility delivery for women living >10 km from a health facility including adolescents and primigravidas in Zambia.

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UN Sustainable Development Goals (SDGs)

This publication has contributed to the advancement of the following goals:

#5 Gender Equality
#3 Good Health and Well-Being

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Collaboration types
Domestic collaboration
International collaboration
Web of Science research areas
Obstetrics & Gynecology
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