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UBC Theses and Dissertations

Maternity waiting homes and the impact on maternal mortality in developing countries : a rapid evidence assessment Powell, Stephanie Michelle


The World Health Organization estimates that nearly 830 women die each day from preventable causes related to pregnancy and childbirth, with 99% of all maternal deaths occurring in developing countries. Maternity waiting homes (MWHs) are an intervention dating back to the 1950s, aimed at improving access to emergency and specialized maternity care. Often a stand-alone health care facility located near a larger medical centre or hospital with emergency and high risk maternity services, they provide a safe place for women to stay towards the end of their pregnancies to await the onset of labour. Once a woman goes into labour, she can be quickly transferred to the local hospital for a safe delivery. The facilities have been viewed as a low cost solution to decentralize obstetrical services and improve access to skilled care. However, very limited research has been conducted examining MWHs and their impact on maternal mortality. The purpose of this study was to examine previously published literature to identify the impact MWHs have had on reducing maternal mortality. This study also examined the factors that have been found to influence a woman’s decision and ability to use a MWH. A Rapid Evidence Assessment was conducted examining literature published between 1994 and September 2018. A total of 16 studies were identified, analyzed and critically appraised using three appraisal tools. The research evidence indicates that MWHs provide a protective effect against maternal mortality. Thematic analysis revealed six main factors that influenced a woman’s decision and ability to access a MWH; 1) distance and accessibility; 2) transportation issues; 3) financial costs; 4) physical aspects of MWHs and the services provided; 5) cultural practices/restrictions; and 6) unfamiliarity about the existence of MWHs. Findings from this REA add to a greater understanding of MWHs and their impact on maternal mortality, reaffirming the notion that MWHs continue to be a viable and effective intervention. However, further research is warranted to examine other health outcomes aside from maternal mortality, and ways that MWHs can be improved to better meet the needs of women.

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