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Background: Maternity waiting homes, usually located in rural, low-resource settings, may increase access to skilled care during delivery and ultimately improve maternal-newborn outcomes. Although there are studies exploring maternity waiting homes in rural settings, little is known about interest in and viability of maternity waiting home use in urban environments., Objective: The purpose of this study was to conduct a qualitative needs assessment about establishing a maternity waiting home as a health system strengthening intervention in urban Kumasi, Ghana., Design: We conducted an exploratory qualitative needs assessment about the community beliefs, values, and interest in maternity waiting homes as a health system strengthening intervention to improve maternal-newborn outcomes. A semi-structured interview guide was based on several domains from the Tailored Implementation for Chronic Diseases checklist. Latent content analysis was used to analyze the data and elicit themes., Setting: Data were collected in late 2019 in urban Kumasi, Ghana near a large government hospital and in the community., Participants: Using purposive and snowball sampling, individual interviews (n = 14) were conducted with community stakeholders and key decision makers, and 8 focus group discussions were conducted with women of childbearing age (n = 38) and family members (n = 38)., Findings: Three major overarching themes were identified: (1) Urban maternity waiting homes are perceived to provide a unique benefit; (2) Urban maternity waiting homes are anticipated to be successful, and; (3) barriers to establishing an urban maternity waiting home may prevent prompt action. There is community buy-in and engagement for building and using urban maternity waiting homes but they are not able to identify concrete sources of funding to pay for the physical construction of the home., Key Conclusions: There is overwhelming support for building and using maternity waiting homes as a health system strengthening intervention to improve maternal-newborn outcomes in urban Kumasi, Ghana. Participants perceive maternity waiting homes as providing unique benefits to improve maternal-newborn health and anticipate that maternity waiting homes would be a successful intervention. Participants identified financial barriers to establishing an urban maternity waiting home that might prevent timely implementation., Implications for Practice: Findings highlight interest in mobilizing resources to establish maternity waiting homes in an urban setting. To overcome potential barriers to roll-out, attention needs to be focused on securing funding to build an urban maternity waiting home in Kumasi. As health policy shifts towards women delivering in larger-volume facilities typically located in big cities, there is potential for maternity waiting homes to be implemented in urban settings throughout sub-Saharan Africa to maximize positive health outcomes., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

Background and Purpose: An exploratory latent class analysis (LCA) was performed assessing the association between maternity waiting home (MWH) use and maternal-newborn care knowledge., Methods: A two-group comparison design using a face-to-face interview ( n = 250) was conducted to understand if MWH use was associated with greater maternal knowledge of newborn care., Results: High levels of maternal knowledge of newborn care were associated with MWH use. Mothers with low levels of knowledge were less likely to use an MWH prior to delivery and more likely to have fewer pregnancies, attend less than four antenatal care (ANC) visits, and receive no education about newborn health problems during ANC., Conclusions: Nurses need to target younger, primigravida mothers attending fewer ANC visits with educational opportunities while advocating for expansion of health education at MWHs to potentiate long-term benefits for improved maternal-newborn health and delivery outcomes., (© Copyright 2021 Springer Publishing Company, LLC.)

To share her story, we interviewed Agness Mseteka about her experience as a maternity waiting home (MWH) caretaker at the district hospital in rural Lundazi, Zambia. Maternity waiting homes, also known as mother's shelters, are structures built near healthcare facilities to minimize the critical barrier of distance to accessing maternal health services. Agness' story highlights the central role caretakers play in contributing to the successful implementation and sustainability of MWH interventions. Agness is well positioned to be an agent of positive change by bringing health education to pregnant women. An important lesson learned from Agness' story is the need for future research to explore the sustainability of MWHs and long-term effectiveness of income generating activities by the community after the completion of externally funded implementing programs., Competing Interests: The authors have no competing interests to declare., (Copyright: © 2021 The Author(s).)

As highlighted in the International Year of the Nurse and the Midwife, access to quality nursing and midwifery care is essential to promote maternal-newborn health and improve survival. One intervention aimed at improving maternal-newborn health and reducing underutilization of pregnancy services is the construction of maternity waiting homes (MWHs). The purpose of this study was to assess whether there was a significant change in antenatal care (ANC) and postnatal care (PNC) attendance, family planning use, and vaccination rates before and after implementation of the Core MWH Model in rural Zambia. A quasi-experimental controlled before-and-after design was used to evaluate the impact of the Core MWH Model by assessing associations between ANC and PNC attendance, family planning use, and vaccination rates for mothers who gave birth to a child in the past 13 months. Twenty health care facilities received the Core MWH Model and 20 were identified as comparison facilities. Before-and-after community surveys were carried out. Multivariable logistic regression were used to assess the association between Core MWH Model use and ANC and PNC attendance. The total sample includes 4711 mothers. Mothers who used the Core MWH Model had better ANC and PNC attendance, family planning use, and vaccination rates than mothers who did not use a MWH. All mothers appeared to fare better across these outcomes at endline. We found an association between Core MWH Model use and better ANC and PNC attendance, family planning use, and newborn vaccination outcomes. Maternity waiting homes may serve as a catalyst to improve use of facility services for vulnerable mothers., Competing Interests: The authors have declared that no competing interests exist.

Maternity waiting homes (MWHs) may offer an intervention to improve newborn outcomes in rural Zambia. This study compared maternal knowledge of newborn care for women referred from facilities with and without MWHs. Topics assessed included: (1) umbilical cord care; (2) thermal and skin care; (3) nutrition, and; (4) prevention of diarrhea, and; (5) newborn danger signs prompting care-seeking. A two-group comparison design with a convenience sample was employed using a face-to-face interviews at one district hospital. Descriptive, inferential, and multivariate analyses were employed to compare knowledge. Overall, mothers demonstrated newborn care knowledge in accordance with World Health Organization (WHO) guidelines for newborn health and there were no significant differences in maternal knowledge of newborn care practices among MWH and non-MWH users. Younger mothers more often did not know about umbilical cord care, newborn skin care, and newborn danger signs. MWH users went more often for antenatal care than non-MWH users. In both groups, we found as the number of ANC visits increases, odds of answering "Don't know" decreases. This study is the first to assess maternal newborn care knowledge and MWH use in rural Zambia. Both MWH users and non-users in the rural district were knowledgeable about essential newborn care.

Objective: To analyze the cost-effectiveness of maternity waiting homes (MWHs) in rural Liberia by examining the cost per life saved and economic effect of MWHs on maternal mortality., Methods: A cost-effectiveness analysis was used to evaluate costs and economic effect of MWHs on maternal mortality in rural Liberia to guide future resource allocation. A secondary data analysis was performed based on a prior quasi-experimental cohort study of 10 rural primary healthcare facilities, five with a MWH and five without a MWH, that took place from October 30, 2010 to February 28, 2015., Results: Calculations signified a low cost per year of life saved at MWHs in a rural district in Liberia. Total population-adjusted number of women's lives saved over 3 years was 6.25., Conclusion: While initial costs were considerable, over a period of 10 or more years MWHs could be a cost-effective and affordable strategy to reduce maternal mortality rates in Liberia. Discussion of the scaling up of MWH interventions for improving maternal outcomes in Liberia and other low- and middle-income countries is justified. Findings can be used to advocate for policy changes to increase the apportionment of resources for building more MWHs in low resource settings., (© 2019 International Federation of Gynecology and Obstetrics.)

Objectives Decreasing neonatal morbidity and mortality remains a challenge in low resource settings. Maternity waiting homes (MWHs) may offer a way to better provide perinatal obstetric care and improve newborn outcomes. The purpose of this scoping review is to examine the impact of MWHs on newborn outcomes and to inform the development of targeted interventions and services to decrease neonatal mortality. Methods A literature search of four databases in the fields of nursing, medicine and global health was conducted yielding a total of 11 articles included for the review. Results Results indicate studies with extremely limited qualitative or quantitative measures of the impact of MWHs on neonatal health. Conclusions An exceptionally wide gap in knowledge on the outcomes of neonates born at MWHs was identified through this scoping review of the scientific literature. The review illustrates the need for more research to understand the effectiveness of MWHs on newborn morbidity and mortality. An increased focus on the study of MWHs for improving newborn outcomes in low resource settings merits immediate attention.