Maternity waiting homes and traditional midwives in rural Liberia

  • International Journal of Gynecology and Obstetrics, Volume 123, No. 2, Year 2013

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Study Justification:
– Maternity waiting homes (MWHs) can reduce maternal morbidity and mortality by increasing access to skilled birth attendants (SBAs).
– This study aims to determine the impact of MWHs on the use of SBAs in rural primary health clinics in Liberia.
– It also examines the ability of traditional midwives (TMs) to work with SBAs as a team and their perceptions of the collaboration.
– Additionally, the study investigates whether MWHs contribute to a decrease in maternal and child morbidity and mortality.
Highlights:
– Communities with MWHs experienced a significant increase in team births from baseline to post-intervention (10.8% versus 95.2%, P < 0.001).
– Greater engagement between TMs and SBAs was observed in communities with MWHs.
– Lower rates of maternal and perinatal death were reported in communities with MWHs.

Recommendations:
– The establishment of MWHs is an effective strategy to increase the use of SBAs and improve collaboration between SBAs and TMs.
– MWHs should be implemented in rural areas to improve maternal and neonatal health outcomes.

Key Role Players:
– Ministry of Health: Responsible for policy development and implementation.
– Health Clinics: Provide the infrastructure and resources for MWHs.
– Skilled Birth Attendants: Deliver care and support at MWHs.
– Traditional Midwives: Collaborate with SBAs and provide their expertise.
– Community Leaders: Advocate for the establishment and maintenance of MWHs.

Cost Items for Planning Recommendations:
– Construction and maintenance of MWHs: Includes building materials, labor costs, and ongoing maintenance expenses.
– Training and capacity building for SBAs and TMs: Covers workshops, educational materials, and trainers’ fees.
– Medical equipment and supplies: Includes essential items for safe deliveries and postnatal care.
– Transportation: Budget for transportation of SBAs and TMs to and from MWHs.
– Monitoring and evaluation: Funds for data collection, analysis, and reporting on the impact of MWHs.

Please note that the provided cost items are general categories and not specific cost estimates.

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Objective: Maternity waiting homes (MWHs) can reduce maternal morbidity and mortality by increasing access to skilled birth attendants (SBAs). The present analysiswas conducted to determinewhetherMWHs increase the use of SBAs at rural primary health clinics in Liberia; to determinewhether traditionalmidwives (TMs) are able to work with SBAs as a team and to describe the perceptions of TMs as they engage with SBAs; and to determine whether MWHs decrease maternal and child morbidity and mortality. Methods: The present analysis was conducted halfway through a large cohort study in which 5 Liberian communities received the intervention (establishment of anMWH) and 5 Liberian communities did not control group). Focus groups were conducted to examine the views of TMs on their integration into health teams. Results: Communities with MWHs experienced a significant increase in team births from baseline to post-intervention (10.8% versus 95.2%, P < 0.001), with greater TM engagement. Lower rates of maternal and perinatal death were reported from communities with MWHs. Conclusion: The reduction in morbidity and mortality indicates that the establishment of MWHs is an effective strategy to increase the use of SBAs, improve the collaboration between SBAs and TMs, and improve maternal and neonatal health. © 2013 Published by Elsevier Ireland Ltd. on behalf of International Federation of Gynecology and Obstetrics.

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The recommendation to improve access to maternal health in rural areas is the establishment of maternity waiting homes (MWHs). MWHs have been shown to reduce maternal morbidity and mortality by increasing access to skilled birth attendants (SBAs). This recommendation is based on a study conducted in Liberia, where communities with MWHs experienced a significant increase in team births and greater engagement between traditional midwives (TMs) and SBAs. Lower rates of maternal and perinatal death were also reported in communities with MWHs. The findings of this study were published in the International Journal of Gynecology and Obstetrics in 2013.
AI Innovations Description
The recommendation to improve access to maternal health is the establishment of maternity waiting homes (MWHs) in rural areas. MWHs can reduce maternal morbidity and mortality by increasing access to skilled birth attendants (SBAs). This recommendation is based on a study conducted in Liberia, where communities with MWHs experienced a significant increase in team births and greater engagement between traditional midwives (TMs) and SBAs. Additionally, lower rates of maternal and perinatal death were reported in communities with MWHs. This suggests that the establishment of MWHs is an effective strategy to increase the use of SBAs, improve collaboration between SBAs and TMs, and improve maternal and neonatal health. The findings of this study were published in the International Journal of Gynecology and Obstetrics in 2013.
AI Innovations Methodology
The methodology used in the study to simulate the impact of the recommendations on improving access to maternal health involved the following steps:

1. Study Design: The study used a cohort design, where 5 Liberian communities received the intervention (establishment of maternity waiting homes) and 5 communities did not (control group).

2. Intervention: Maternity waiting homes (MWHs) were established in the intervention communities to increase access to skilled birth attendants (SBAs). The MWHs provided a safe place for pregnant women to stay near the primary health clinics before giving birth.

3. Data Collection: Data was collected halfway through the study to assess the impact of the intervention. Focus groups were conducted to gather the views of traditional midwives (TMs) on their integration into health teams and their engagement with SBAs.

4. Outcome Measures: The study measured the use of SBAs, team births, and rates of maternal and perinatal death in communities with MWHs compared to those without.

5. Data Analysis: Statistical analysis was performed to compare the baseline and post-intervention data. The researchers used appropriate statistical tests to determine the significance of the findings.

6. Results: The study found that communities with MWHs experienced a significant increase in team births and greater engagement between TMs and SBAs. Lower rates of maternal and perinatal death were also reported in communities with MWHs.

7. Conclusion: Based on the findings, the study concluded that the establishment of MWHs is an effective strategy to increase the use of SBAs, improve collaboration between SBAs and TMs, and improve maternal and neonatal health.

This methodology allowed the researchers to assess the impact of the recommendations on improving access to maternal health by comparing communities with MWHs to those without. The findings provide evidence for the effectiveness of MWHs in reducing maternal morbidity and mortality.


Statistics:
Citations: 49
Identifiers:
DOI: 10.1016/j.ijgo.2013.05.024
ISSN: 00207292
Research Areas:
Community Interventions, Health System and Policy, Maternal and Child Health, Workforce
Study Countries:
Liberia
Study Design:
Cohort Study, randomised-control-trial
Study Approach:
Quantitative
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