Dataset Information

Magnitude and factors influencing pastoralist women's maternity waiting home utilization in Teltelle district, Ethiopia: A cross-sectional study.

ABSTRACT:

Background and aims

Pastoralists in Ethiopia benefit the least from health-sector advances compared to the country's agrarian population. Maternity waiting homes (MWHs) have been established to provide mothers living in remote regions with access to skilled healthcare services during pregnancy, delivery, and postpartum periods. However, there is a dearth of data on the utilization of MWHs in pastoralist areas.

Objectives

To assess maternity waiting home utilization and its associated factors among pastoralist women who gave birth in the last 12 months in Teltelle district, Southeastern Ethiopia; 2021.

Methods

A community-based cross-sectional study was undertaken from March 1 to June 20, 2021. A multistage sampling technique was used to select the 458 study subjects. A pretested structured questionnaire was used to gather the data. For data entry and analysis, Epi-data version 4.4.3.1 and SPSS version 25.0 were utilized respectively. Models of bivariate and multivariate logistic regression were utilized to identify associated factors. In the multivariable analysis, variables with p < 0.05 were declared significantly associated with maternity waiting home utilization.

Result

A total of 458 pastoralist women participated in the study. From the total participants, 26.64% [95% confidence interval: 22.57%-30.70%] of women utilized MWHs. Women's husband education status, complications during their last pregnancy, family support to MWHs, and community involvement and support were found to be significantly associated with the utilization of MWHs.

Conclusion and recommendation

This study found that utilization of MWHs was significantly lower in pastoralist areas of Ethiopia than in agrarian areas. Previous pregnancy complications, family support, husband's literacy, and community support were all significantly associated with improved maternity waiting home utilization. Encouraging community participation and family support are recommended to improve its utilization. Moreover, increasing community involvement in MWHs establishment and sustainability will be expected from the stakeholders.

SUBMITTER: Bedada FW

PROVIDER: S-EPMC10320747 | biostudies-literature | 2023 Jul

REPOSITORIES: biostudies-literature

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Publications

Magnitude and factors influencing pastoralist women's maternity waiting home utilization in Teltelle district, Ethiopia: A cross-sectional study.

Bedada Firaol Worku FW Wendimu Debisa Eshatu DE Daba Derese Bekele DB Degefa Mosisaa Bekele MB

Health science reports 20230705 7

<h4>Background and aims</h4>Pastoralists in Ethiopia benefit the least from health-sector advances compared to the country's agrarian population. Maternity waiting homes (MWHs) have been established to provide mothers living in remote regions with access to skilled healthcare services during pregnancy, delivery, and postpartum periods. However, there is a dearth of data on the utilization of MWHs in pastoralist areas.<h4>Objectives</h4>To assess maternity waiting home utilization and its associa ...[more]

PMID: 37415677

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Project description:BackgroundMaternity Waiting Homes (MWHs) have been advocated to improve the utilization of skilled birth attendants. Nevertheless, delivery attended by skilled personnel is low in Ethiopia and may indicate that the utilization of MWH is also low. The aim of this study is to explore the factors influencing women's access to the MWHs in rural Southwest Ethiopia.MethodsQualitative data were collected through focus group discussions with MWHs users and in-depth interviews with MWHs non-users, health extension workers and the clinicians. Four focus group discussions and 18 in-depth interviews were conducted between May 1 and June 1, 2017. Furthermore, observations were made to assess the availability of basic facilities at selected MWHs. Data were thematically analyzed using NVivo version 7. The concept of access defined by Thiede et al was applied to guide the analysis.ResultsWomen had interest on MWHs and are aware of the existence of MWHs in their immediate vicinity. Health information disseminations and referral linkages by frontline health workers enabled women to timely access the MWHs. However, Women didn't understand the aims and benefits of MWHs. At the facility level, there were attempts to improve the acceptability of MWHs by allowing women to choose their delivery positions. But, participants claimed lack of privacy and presence of disrespectful care. Physical barriers (long distance, unavailability of transport options & unfavorable roads) were considered as potential problems for women residing in remote areas. MWH users mentioned absences of sufficient basic facilities, poor quality and varieties of food. Because of insufficient facilities, the cost of living was high for most users. The communities try to overcome the indirect costs through contributions in-kind and in-cash.ConclusionsThe factors influencing women's access to the MWHs were structural and individual and resonate with Thiede et al. dimensions of access. A better understanding of which factors are most influential in preventing women's access to the MWHs in rural Southwest Ethiopia is needed to appropriately target interventions.

Project description:BackgroundMaternity waiting home (MWH) is a direct strategy to improve newborn and maternal survival. The utilization of MWH, however, remains very low in Ethiopia. Men involvement in maternal health programs is a key strategy to increase utilization of maternal health services, including MWH. This study defines men involvement in-terms of men's participation in deciding to admit their spouse to an MWH, accompanying their spouse to an MWH, providing financial support, availing food at an MWH, and taking care of the home or children. Thus, the current study aims to identify factors affecting men's involvement in MWH utilization.MethodsA community-based cross-sectional study was conducted from October 1st to December 30th, 2018. Four hundred three men were involved in the study. Data were analyzed by the statistical package for social science (SPSS) version 23. Independent predictors were identified by a multivariable logistic regression model. Adjusted odds ratios (AORs) with 95% confidence intervals (CIs) were reported.ResultsMen's involvement in MWH was 55.6% (50.71, 60.45). Age (AOR = 0.86, 95% CI = 0.82-0.94), knowledge about MWH (AOR = 4.74, 95% CI = 2.65-8.49), decision-making power (AOR = 4.00, 95% CI = 1.38-11.57), and receiving counseling about MWH during spousal antenatal care visits (AOR = 9.15, 95% CI = 3.34-25.03) had statistically significant associations with men's involvement in MWH utilization.ConclusionsNearly, half of the male partners were involved in MWH utilization. Men's age, MWH knowledge, decision-making power, and receiving counseling were factors affecting their involvement in MWH utilization. Interventions targeting to improve male involvement in MWH utilization should focus on building men's knowledge about MWH, increasing male involvement in ANC with an appropriate level of counseling about MWH, and changing patriarchal thinking in society with appropriate behavioral interventions such as community-based health education.

Project description:BackgroundMaternity Waiting Home (MWH) utilization is valuable for enhancing maternal and neonatal health service utilization. Although few studies have been conducted in non-pastoral areas, more evidence is needed from pastoralist communities. Hence, the study aimed to assess the utilization of MWH and its associated factors among women in pastoralist communities in Ethiopia.MethodsA concurrent mixed-method design was conducted from 10 Augustto15 September 2021. The cluster sampling technique was used to select the study participants. Qualitative data was collected through focus group discussions and in-depth interviews. Multivariable logistic regression analysis is used to identify significant factors. Qualitative data were thematically analyzed and triangulated with quantitative findings.ResultsOnly 13 % (95%CI:10.5-15.6) of women had utilized MWHs. Husbands participation in antenatal care (AOR = 5.54, 95%CI: 2.14-14.35), having caregivers at home (AOR = 2.59, 95%CI: 1.14-4.86), attending pregnant-women conferences (AOR = 5.01, 95%CI: 2.17-11.49), the husband received information about MWH (AOR = 3.6, 95%CI: 1.54-8.49), favorable attitude towards MWH (AOR = 3.15, 95%CI:1.47-6.77), birth during the rainy season (AOR = 0.35, 95%CI: 0.15-0.81) and residing within 10 km of a health center (AOR = 0.15,95%CI:0.04-0.58) were significantly associated with MWH utilization. The main themes that emerged as barriers to MWH utilization were lack of awareness, availability and accessibility of the services, norms and perceptions, lack of decision-making power, family support and women's workload.ConclusionThe study found low utilization of MWHs. Husbands' involvement, having information about MWHs, a favorable attitude, the season of birth, and distance were significantly associated. Lack of transportation access, norms, and limited awareness of MWH were also found to be barriers to service utilization. Health education to raise awareness about the importance of MWHs, enabling transportation access, husbands' involvement, and encouraging women to take an active role in household decision-making are crucial to boosting MWH utilization.

Project description:BackgroundApproximately 80% of people in Ethiopia live in rural areas, where poor access to maternity services, accounts for the majority of maternal and perinatal deaths. Maternity waiting homes are residential facilities for women who come from remote areas to stay and wait before giving birth at health facilities, particularly in hospitals and health centers. It is a new initiative and one of the strategies that increase skilled care utilization at birth. However, there is no evidence on the status of maternity waiting home utilization in the study area. Therefore, this study aimed to generate evidence on the status of maternity waiting home utilization and its associated factors.MethodsA community-based cross-sectional household survey was conducted from June 5-30, 2022. The sample size was calculated using the single population proportion formula, which resulted in 354 participants. The study population included mothers who gave birth within 12 months before the survey were selected by using a systematic sampling method. The data were coded, edited, cleaned, and entered into Epi Data version 3.1. The data were subsequently exported to SPSS version 25 for analysis. Descriptive, bivariable, and multivariable binary logistic regression analyses were performed. The results are presented in the text, figures, and tables. Finally, variables with a p value < 0.05 in the multivariable analysis were reported as significantly associated with the independent variables and outcome variable.ResultsThe magnitude of maternity waiting home utilization was 36.4% (95% CI = 31.4, 41.8). Being knowledgeable about the presence of maternity waiting home (AOR = 3.9; 95% CI: 1.0-15.2), being able to afford transportation (AOR = 2.4; 95% CI: 1.01-5.9), being home delivery (AOR = 0.007; 95% CI: 0.002-0.031) and being acess to transportation services (AOR = 3.0; 95% CI: 1.2-7.5) were significantly associated with maternity waiting home utilization.ConclusionThe magnitude of maternity waiting home utilization in the study area was found to be low. Access to and affordability of transportation services, being knowledgeable and being home delivery were associated factors for the use of maternity waiting homes. Therefore, increasing maternal knowledge, economically empowering women and respecting care while waiting at maternity homes are important for improving the utilization of maternity waiting homes.

Project description:BackgroundMaternal mortality and adverse pregnancy outcomes are still challenges in developing countries. In Ethiopia, long distances and lack of transportation are the main geographic barriers for pregnant women to utilize a skilled birth attendant. To alleviate this problem, maternity waiting homes are a gateway for women to deliver at the health facilities, thereby helping towards the reduction of the alarming maternal mortality trend and negative pregnancy outcomes. However, there is a paucity of evidence regarding the utilization of maternity waiting homes in the study area. Therefore, this study aimed to assess utilization of maternity waiting home services and associated factors among mothers who gave birth in the last year in Dabat district, northwest Ethiopia.MethodsA community-based cross-sectional study was conducted from January 5 to February 30, 2019. A total of 402 eligible women were selected using a simple random sampling technique. Data were collected using a structured, pre-tested, and interviewer-administered questionnaire through face-to-face interviews. Data were entered into EPI info version 7.1.2 and exported to SPSS version 20 for analysis. Both bivariable and multivariable logistic regression models were fitted. Statistically significant associations between variables were determined based on the adjusted odds ratio (AOR) with its 95% confidence interval and p-value of ≤ 0.05.ResultsMaternity waiting home utilization by pregnant women was found to be 16.2% (95% CI: 13, 20). The mothers' age (26-30 years) (AOR = 0.24; 95% CI: 0.08,0.69), primary level of education (AOR = 9.05; 95% CI: 3.83, 21.43), accepted length of stay in maternity waiting homes (AOR = 3.15; 95% CI: 1.54, 6.43), adequate knowledge of pregnancy danger signs (AOR = 7.88; 95% CI: 3.72,16.69), jointly decision on the mother's health (AOR = 2.76; 95% CI: 1.08,7.05), and getting people for household activities (AOR = 2.59, 95% CI: 1.21, 5.52) had significant association with maternity waiting home utilization.ConclusionIn this study, maternity waiting home utilization was low. Thus, expanding a strategy to improve women's educational status, health education communication regarding danger signs of pregnancy, empowering women's decision-making power, and shortening the length of stay at maternity waiting homes may enhance maternity waiting home utilization.

Project description:BackgroundA strategy for reducing adverse pregnancy outcomes is the expanded implementation of maternity waiting homes (MWHs). We assessed factors influencing MWH use, as well as the association between MWH stay and obstetric outcomes in a hospital in rural Ethiopia.MethodsData from medical records of the Glenn C. Olson Memorial Primary Hospital obstetric ward were cross matched with records from the affiliated MWH between 1 and 2011 to 31 March 2014. Poisson regression with robust variance was conducted to estimate the relative risk (RR) of childbirth complications associated with MWH use vs. non-use. Five key informant interviews of a convenience sample of three MWH staff and two users were conducted and a thematic analysis performed of social, cultural, and economic factors underlying MWH use.ResultsDuring the study period, 489 women gave birth at the hospital, 93 of whom were MWH users. Common reasons for using the MWH were post-term status, previous caesarean section/myomectomy, malposition/malpresentation, and low-lying placenta, placenta previa, or antepartum hemorrhage, and hypertension or preeclampsia. MWH users were more likely than non-users to have had a previous caesarean Sec. (15.1 % vs. 5.3 %, p < 0.001) and to be post-term (21.5 % vs. 3.8 %, p < 0.001). MWH users were also more likely to undergo a caesarean Sec. (51.0 % vs. 35.4 %, p < 0.05) and less likely (p < 0.05) to have a spontaneous vaginal delivery (49.0 % vs. 63.6 %), obstructed labor (6.5 % vs. 14.4 %) or stillbirth (1.1 % vs. 8.6 %). MWH use (N = 93) was associated with a 77 % (adjusted RR = 0.23, 95 % Confidence Interval (CI) 0.12-0.46, p < 0.001) lower risk of childbirth complications, a 94 % (adjusted RR = 0.06, 95 % CI 0.01-0.43, p = 0.005) lower risk of fetal and newborn complications, and a 73 % (adjusted RR = 0.27, 95 % CI 0.13-0.56, p < 0.001) lower risk of maternal complications compared to MWH non-users (N = 396). Birth weight [median 3.5 kg (interquartile range 3.0-3.8) vs. 3.2 kg (2.8-3.5), p < 0.001] and 5-min Apgar scores (adjusted difference = 0.25, 95 % CI 0.06-0.44, p < 0.001) were also higher in offspring of MWH users. Opportunity costs due to missed work and need to arrange for care of children at home, long travel times, and lack of entertainment were suggested as key barriers to MWH utilization.ConclusionsThis observational, non-randomized study suggests that MWH usage was associated with significantly improved childbirth outcomes. Increasing facility quality, expanding services, and providing educational opportunities should be considered to increase MWH use.

Project description:BackgroundA maternity waiting home is a temporary residence in which pregnant women from remote areas wait for their childbirth. It is an approach targeted to advance access to emergency obstetric care services especially, in hard-to-reach areas to escalate institutional delivery to reduce complications that occur during childbirth. Apart from the availability of this service, the intention of pregnant women to utilize the existing service is very important to achieve its goals. Thus, this study aimed to assess the intention to use maternity waiting homes and associated factors among pregnant women.MethodsCommunity-based cross-sectional study was conducted among 605 pregnant women using a multistage sampling technique from March 10 to April 10, 2019, by using a structured questionnaire through a face-to-face interview. The collected data was entered into Epi-Data version 3.1 and analyzed using the SPSS version 24 statistical package. Logistic regression analysis was used to test the association. All variables at p-value < 0.25 in bivariate analysis were entered into multivariate analysis. Lastly, a significant association was declared at a P-value of < 0.05 with 95% CI.ResultsIn this study, the intention to use maternity waiting homes was 295(48.8%, 95%CI: 47%-55%)). Occupation (government employee) (AOR:2.87,95%CI: 1.54-5.36), previous childbirth history (AOR:2.1,95%CI:1.22-3.57), past experience in maternity waiting home use AOR:4.35,95%CI:2.63-7.18), direct (AOR:1.57,95%CI:1.01-2.47) and indirect (AOR: 2.18, 1.38,3.44) subject norms and direct (AOR:3.00,95%CI:2.03-4.43), and indirect (AOR = 1.84,95%CI:1.25-2.71) perceived behavioral control of respondents were significantly associated variables with intention to use maternity waiting home.ConclusionThe magnitude of intention to use maternity waiting homes among pregnant women is low. Community disapproval, low self-efficacy, maternal employment, history of previous birth, and past experiences of MWHs utilization are predictors of intention to use MWHs, and intervention programs, such as health education, strengthening and integration of community in health system programs need to be provided.

Dataset Information

Magnitude and factors influencing pastoralist women's maternity waiting home utilization in Teltelle district, Ethiopia: A cross-sectional study.

Background and aims

Objectives

Methods

Result

Conclusion and recommendation

Publications

Magnitude and factors influencing pastoralist women's maternity waiting home utilization in Teltelle district, Ethiopia: A cross-sectional study.

Similar Datasets

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