Personal and environmental factors associated with the utilisation of maternity waiting homes in rural Zambia

BMC Pregnancy and Childbirth

Research Article

Karlijn Massar¹  Robert A. C. Ruiter¹  Cephas Sialubanje²  Davidson H. Hamer³ 

[1]Department of Work and Social Psychology, Maastricht University, P.O. Box 616, 6200MD, Maastricht, The Netherlands

[2]Ministry of Health, Monze District Medical Office, P.O. Box 660144, Monze, Zambia

[3]Department of Work and Social Psychology, Maastricht University, P.O. Box 616, 6200MD, Maastricht, The Netherlands

[4]Zambia Centre for Applied Health Research and Development, P.O. Box 30910, Lusaka, Zambia

[5]Centre for Global Health and Development Boston University, Crosstown 3rd floor, 801 Massachusetts Avenue, 02118, Boston, MA, USA

[6]Department of Global Health, Boston University School of Public Health, Crosstown 3rd floor, 801 Massachusetts Avenue, 02118, Boston, MA, USA

关键词: Maternal health;    Health seeking behaviour;    Maternity waiting home;    Kalomo;    Zambia;   

DOI  :  10.1186/s12884-017-1317-5

 received in 2016-10-19, accepted in 2017-04-25,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundAlthough the association between the presence of maternity waiting homes (MWHs) and the personal and environmental factors that affect the use of MWHs has been explained in qualitative terms, it has never been tested in quantitative terms. The aim of this study was to test the association between the presence of MWHs and personal and environmental factors that affect the use of MWHs.MethodsA cross-sectional study was conducted using an interviewer-administered questionnaire from 1st July to 31st August, 2014 among 340 women of reproductive age in 15 rural health centres in Kalomo district, Zambia. Tests of association (chi square, logistic regression analysis, odds ratio) were conducted to determine the strength of the association between the presence of MWHs and personal and environmental factors. Differences between respondents who used MWHs and those who did not were also tested.ResultsCompared to respondents from health centres without MWHs, those from centres with MWHs had higher odds of expressing willingness to use MWHs (adjusted odds ratio [aOR] = 4.58; 95% confidence interval [CI]:1.39–15.17), perceived more benefits from using a MWH (aOR =8.63; 95% CI: 3.13–23.79), perceived more social pressure from important others to use MWH (aOR =27.09; 95% CI: 12.23–60.03) and higher personal risk from pregnancy and childbirth related complications (aOR =11.63; 95% CI: 2.52–53.62). Furthermore, these respondents had higher odds of staying at a health centre before delivery (aOR =1.78; 95% CI: 1.05–3.02), giving birth at a health facility (aOR = 3.36; 95% CI: 1.85–6.12) and receiving care from a skilled birth attendant (aOR =3.24; 95% CI: 1.80–5.84). In contrast, these respondents had lower odds of perceiving barriers regarding the use of MWHs (aOR =0.27; 95% CI: 0.16–0.47). Factors positively associated with the use of MWHs included longer distances to the nearest health centre (p = 0.004), higher number of antenatal care (ANC) visits (p = 0.001), higher proportions of complications during ANC (p = 0.09) and women’s perception of benefits gained from staying in a MWH while waiting for delivery at the health centre (p = 0.001).ConclusionThese findings suggest a need for health interventions that focus on promoting ANC use, raising awareness about the risk and severity of pregnancy complications, promoting family and community support, and mitigating logistical barriers.

【 授权许可】

CC BY   
© The Author(s). 2017