Introduction:
Maternal mortality remains a significant public health concern, particularly in low-resource settings such as rural areas of Ethiopia. Skilled care during childbirth is crucial for reducing maternal deaths, and maternity waiting homes (MWHs) have been endorsed as a strategy to facilitate access to such care. However, most pregnant women in rural Ethiopia do not utilize MWHs, indicating the need to understand the factors influencing their intention to use these facilities. A recent study conducted in Bench Maji Zone; Southwest Ethiopia has shed light on the predictors of intention to use MWHs among pregnant women in this region.
Study Findings:
The community-based cross-sectional study involved 829 pregnant women in Bench Maji Zone. The respondents were assessed using the Theory of Planned Behaviour to determine their intention to use MWHs. The study findings revealed the following key predictors:
- Antenatal Care (ANC) Use: The study found a significant association between ANC use and the intention to use MWHs. This suggests that pregnant women who regularly attend ANC visits are more likely to express an intention to use MWHs. Therefore, interventions to improve access to ANC services are crucial for promoting MWH utilization.
- Attitude: The study found that a positive attitude towards MWHs was associated with a higher intention to use these facilities. This highlights the importance of promoting positive perceptions and beliefs about MWHs among pregnant women. Educational programs and awareness campaigns can help dispel misconceptions and emphasize the benefits of utilizing MWHs for safe delivery.
- Subjective Norm: The study found that subjective norm, or the perceived social pressure to use MWHs, significantly influenced the intention to use these facilities. Engaging community members, community leaders, and influential individuals in endorsing and promoting the use of MWHs can help create a supportive social norm. Community engagement activities, such as community dialogues and sensitization sessions, can be implemented to foster a collective understanding and acceptance of MWHs.
- Perceived Behavioural Control: The study found that pregnant women’s perceived control over using MWHs significantly influenced their intention to utilize these facilities. Enhancing women’s knowledge about MWHs, providing information on how to access and utilize MWHs, and addressing any logistical or financial barriers can enhance their sense of control. Additionally, involving healthcare providers and community health workers in providing guidance and support can further enhance perceived behavioural control.
Implications and Recommendations:
Based on the study findings, it is clear that interventions to increase the intention to use MWHs among pregnant women in rural Ethiopia need to be multifaceted. Here are some recommendations for key stakeholders:
- Ministry of Health and Regional Health Bureaus: Prioritize improving access to ANC services by strengthening the health system in rural areas. This can be done through training and capacity building for healthcare providers, ensuring the availability of necessary equipment and supplies, and improving transportation networks.
- Healthcare Providers: Provide comprehensive information and counselling during ANC visits to promote positive attitudes towards MWHs. Emphasize the benefits of utilizing MWHs for safe delivery and address any fears or misconceptions that pregnant women may have.
- Community Health Workers: Engage in community mobilization activities to raise awareness about the importance of MWHs and address any cultural or traditional barriers. Utilize their role as trusted individuals in the community to promote positive attitudes and subjective norms towards MWH utilization.
- Non-Governmental Organizations: Develop educational materials, such as brochures, posters, and videos, to disseminate accurate information about MWHs. Collaborate with local organizations in conducting advocacy and awareness campaigns to promote positive attitudes and subjective norms.
- Community Leaders and Influential Individuals: Engage community leaders and influential individuals to endorse and promote the use of MWHs. Their support and endorsement can play a significant role in shaping the subjective norm surrounding MWH utilization.
- Monitoring and Evaluation: Regularly monitor and evaluate the effectiveness of interventions implemented to increase the intention to use MWHs. Assess the outcomes, identify any gaps or challenges, and make necessary adjustments to ensure the interventions are successful.
Conclusion:
The study conducted in Bench Maji Zone; Southwest Ethiopia provides valuable insights into the predictors of intention to use MWHs among pregnant women. The findings highlight the importance of antenatal care utilization, attitude, subjective norm, and perceived behavioural control in influencing their intention to utilize these facilities. Implementing multidimensional interventions that address these factors can help increase the uptake of MWHs and ultimately contribute to reducing maternal mortality in rural areas. By involving key stakeholders, such as the Ministry of Health, healthcare providers, community health workers, and NGOs, Ethiopia can work towards creating an enabling environment for women to access and utilize MWHs for safe deliveries.
Based on the Following Publications
Predictors of intention to use maternity waiting home among pregnant women in bench Maji zone, southwest Ethiopia using the theory of planned behaviour International Journal of Women’s Health, Volume 12, Year 2020