The Role of Maternity Waiting Homes on Maternal and Newborn Health Outcomes in Sub-Saharan Africa: A Systematic Literature Review

Introduction: Maternity waiting homes (MWHs) are an intervention aimed at improving access to emergency and skilled maternal health services for pregnant women who are at high-risk for pregnancy complications and live long distances away from maternity services (Siabulanje et al., 2015). These facilities are located within close reach to hospitals that are well equipped with emergency obstetric care services (EmOC). The primary aim of this systematic review was to assess current published literature on maternity waiting homes to identify the role they play in maternal, newborn, and child health outcomes, and address the possible factors that contribute to women’s ability and decision to seek care in MWHs. Methods: The author searched PubMed, Scopus, and Global Health for studies reporting on maternity waiting home interventions. Included studies focused on the role in maternal, newborn, and child health and factors that influenced women’s ability and decision in the utilization of these facilities. Relevant data were extracted from each included study and was recorded in Microsoft Excel. Each of the included study and its outcomes was critically assessed for quality using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) conceptual framework. Results: The search produced a total of 390 studies that focused on MWHs and 12 studies met the inclusion criteria, six received a high GRADE rating, five moderate, and one low. Each included study reported on different demographic outcomes. Findings from the literature shows MWH utilization were linked with lower rates of maternal mortality, an increased uptake of antenatal healthcare, increased facility and assisted delivery during labor, and the absence of adverse pregnancy outcomes (uterine rupture, requiring caesarean sections, spontaneous vertex delivery) among MWH users. Factors that influenced women’s decision and ability to seek care at MWHs were heavily influenced by long distances from home to facility, direct and indirect cost linked to MWHs, lack of available transportation, and lack of awareness about MWHs. Studies have shown mixed results for overall women’s quality of satisfaction regarding the physical space of MWHs. Discussion and Conclusion: Current evidence suggests that there are many health benefits associated with MWH utilization among high-risk pregnant women and women who live far distances away from maternity care facilities. There is a need for more evidence-based studies to establish the continuity of quality improvement efforts to increase and sustain MWH utilization.Master of Science in Public Healt