Viability of an urban maternity waiting home in Kumasi, Ghana: A qualitative needs assessment

  • Midwifery, Volume 110, Year 2022

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Study Justification:
– Maternity waiting homes have been shown to improve maternal-newborn outcomes in rural, low-resource settings.
– However, little is known about the interest in and viability of maternity waiting homes in urban environments.
– This study aims to conduct a qualitative needs assessment to explore the establishment of a maternity waiting home in urban Kumasi, Ghana.
Highlights:
– The study conducted individual interviews with community stakeholders and key decision makers, as well as focus group discussions with women of childbearing age and family members.
– Three major themes emerged: (1) Urban maternity waiting homes are perceived to provide unique benefits, (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 overwhelming support for building and using maternity waiting homes in urban Kumasi, Ghana.
– Participants identified financial barriers to establishing an urban maternity waiting home.
Recommendations:
– Mobilize resources to establish maternity waiting homes in urban settings.
– Focus on securing funding to build an urban maternity waiting home in Kumasi.
– Consider implementing maternity waiting homes in urban settings throughout sub-Saharan Africa to maximize positive health outcomes.
Key Role Players:
– Community stakeholders
– Key decision makers
– Women of childbearing age
– Family members
– Health system administrators
– Government officials
– Non-governmental organizations (NGOs)
– Donors or funding agencies
Cost Items for Planning Recommendations:
– Construction of the maternity waiting home
– Infrastructure development (e.g., water supply, electricity)
– Furnishing and equipment for the home
– Staff salaries and training
– Operational costs (e.g., maintenance, utilities)
– Community engagement and awareness campaigns
– Monitoring and evaluation activities
– Research and data collection
– Administrative and logistical support

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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.

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The recommendation from the study titled “Viability of an urban maternity waiting home in Kumasi, Ghana: A qualitative needs assessment” is to establish a maternity waiting home as a health system strengthening intervention in urban Kumasi, Ghana. The study found overwhelming support for building and using maternity waiting homes to improve maternal-newborn outcomes in the urban setting. Participants perceived maternity waiting homes as providing unique benefits and anticipated their success as an intervention.

However, the study also identified financial barriers that may prevent the timely implementation of an urban maternity waiting home. To overcome these barriers, attention needs to be focused on securing funding for the physical construction of the home. The findings highlight the interest in mobilizing resources to establish maternity waiting homes in urban settings, particularly in larger-volume facilities located in big cities.

Implementing maternity waiting homes in urban settings throughout sub-Saharan Africa has the potential to maximize positive health outcomes as health policy shifts towards women delivering in larger facilities. This recommendation is published in the journal Midwifery, Volume 110, in the year 2022.
AI Innovations Description
The recommendation from the study titled “Viability of an urban maternity waiting home in Kumasi, Ghana: A qualitative needs assessment” is to establish a maternity waiting home as a health system strengthening intervention in urban Kumasi, Ghana. The study found overwhelming support for building and using maternity waiting homes to improve maternal-newborn outcomes in the urban setting. Participants perceived maternity waiting homes as providing unique benefits and anticipated their success as an intervention.

However, the study also identified financial barriers that may prevent the timely implementation of an urban maternity waiting home. To overcome these barriers, attention needs to be focused on securing funding for the physical construction of the home. The findings highlight the interest in mobilizing resources to establish maternity waiting homes in urban settings, particularly in larger-volume facilities located in big cities.

Implementing maternity waiting homes in urban settings throughout sub-Saharan Africa has the potential to maximize positive health outcomes as health policy shifts towards women delivering in larger facilities. This recommendation is published in the journal Midwifery, Volume 110, in the year 2022.
AI Innovations Methodology
Based on the provided description, here are some potential recommendations for innovations to improve access to maternal health:

1. Mobile Maternity Waiting Homes: Develop a mobile maternity waiting home that can be transported to different urban areas, providing temporary accommodation for pregnant women near healthcare facilities. This would address the challenge of limited physical space in urban environments.

2. Public-Private Partnerships: Establish partnerships between the government, private sector, and non-profit organizations to fund and operate maternity waiting homes in urban areas. This would help overcome the financial barriers identified in the study.

3. Telemedicine and Teleconsultations: Implement telemedicine services to provide remote consultations and support for pregnant women in urban areas. This would enhance access to healthcare professionals and reduce the need for physical visits to healthcare facilities.

4. Community-Based Maternal Health Workers: Train and deploy community health workers specifically focused on maternal health in urban areas. These workers can provide education, support, and referrals to pregnant women, ensuring they receive timely and appropriate care.

To simulate the impact of these recommendations on improving access to maternal health, a methodology could include the following steps:

1. Define the parameters: Clearly define the target population, geographic area, and timeframe for the simulation.

2. Data collection: Gather relevant data on the current state of maternal health access in the urban area of interest. This may include information on healthcare facilities, population demographics, and existing barriers to access.

3. Model development: Develop a simulation model that incorporates the proposed innovations and their potential impact on improving access to maternal health. This could involve creating mathematical equations or using simulation software to represent the interactions between different variables.

4. Input data and assumptions: Input the collected data into the simulation model, along with assumptions about the effectiveness and reach of the innovations. This may include factors such as the number of mobile maternity waiting homes, the level of community engagement, or the availability of telemedicine services.

5. Run simulations: Run multiple simulations using different scenarios and parameters to assess the potential impact of the innovations on improving access to maternal health. This could involve varying factors such as the number of pregnant women reached, the reduction in travel time to healthcare facilities, or the increase in utilization of maternal health services.

6. Analyze results: Analyze the simulation results to determine the potential benefits and limitations of each innovation. This could include assessing changes in maternal health outcomes, cost-effectiveness, or equity in access.

7. Refine and iterate: Based on the analysis, refine the simulation model and assumptions as needed. Repeat the simulations to further explore the potential impact of the innovations and identify the most effective strategies.

By following this methodology, policymakers and stakeholders can gain insights into the potential impact of different innovations on improving access to maternal health in urban areas, helping them make informed decisions and allocate resources effectively.

Statistics:
Authors: 3
Identifiers:
DOI: 10.1016/j.midw.2022.103349
ISSN: 02666138
Research Areas:
Community Interventions, Health System and Policy, Maternal Access, Maternal and Child Health, Quality of Care, Social Determinants
Study Countries:
Ghana
Study Design:
Exploratory Study, randomised-control-trial
Study Approach:
Qualitative
Participants Gender:
Female
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