Safe Motherhood: Maternity Waiting Homes in Ethiopia to Improve Women’s Access to Maternity Care

Waiting for quality maternity care in rural Ethiopia A study into determinants of Maternity Waiting Home use in rural Ethiopia Tienke Vermeiden (Prof. Dr. J. Stekelenburg, Prof. Dr. T. van den Akker) Women have the universal right to a healthy pregnancy and childbirth. Despite a notable global reduction in maternal and child mortality, still approximately 300,000 women and more than five million babies die every year from complications of pregnancy and/or childbirth. Almost all of these tragic events occurred in low- and middle-income countries, and could have been prevented had these women received adequate care before, during and after childbirth. A Maternity Waiting Home (MHW) is targeted at women with a high-risk pregnancy and/or who have to travel far to get to a health facility. They are recommended to stay at such a residential structure during the last weeks of their pregnancy. As soon as labour starts or complications arise, they move to the adjacent health facility (health centre or hospital). The studies bundled in this thesis were conducted by Tienke Vermeiden and her research team to gain insight into factors that could influence the introduction of MHWs in rural Ethiopia. They answered three specified research questions: 1. What is the impact of MWH use on birth outcomes? 2. Which factors influence MWH use? 3. Can pregnancy complications be treated at health centres? The most crucial finding was: pregnant women, especially those with a low socio-economic status, experienced many obstacles to staying at an MWH. Being close to high-quality birthing care was considered the most important reason to use the service. However, women were likely to receive substandard care at health facilities, especially at health centres. Maternal and newborn mortality in Ethiopia and other low- and middle-income countries will only decrease further if a health system is capable of absorbing the influx of women to MWHs and health facilities, and can provide high quality care