Abstract:
Objective To identify individual-, household- and
community-level factors associated with maternity waiting
home (MWH) use in Ethiopia.
Design Cross-sectional analysis of baseline household
survey data from an ongoing cluster-randomised controlled
trial using multilevel analyses.
setting Twenty-four rural primary care facility catchment
areas in Jimma Zone, Ethiopia.
Participants 3784 women who had a pregnancy outcome
(live birth, stillbirth, spontaneous/induced abortion) 12
months prior to September 2016.
Outcome measure The primary outcome was selfreported MWH use for any pregnancy; hypothesised
factors associated with MWH use included woman’s
education, woman’s occupation, household wealth,
involvement in health-related decision-making, companion
support, travel time to health facility and community-levels
of institutional births.results Overall, 7% of women reported past MWH use.
Housewives (OR: 1.74, 95% CI 1.20 to 2.52), women with
companions for facility visits (OR: 2.15, 95% CI 1.44 to
3.23), wealthier households (fourth vs first quintile OR:
3.20, 95% CI 1.93 to 5.33) and those with no health
facility nearby or living >30 min from a health facility (OR:
2.37, 95% CI 1.80 to 3.13) had significantly higher odds
of MWH use. Education, decision-making autonomy and
community-level institutional births were not significantly
associated with MWH use.
Conclusions Utilisation inequities exist; women with
less wealth and companion support experienced more
difficulties in accessing MWHs. Short duration of stay and
failure to consider MWH as part of birth preparedness
planning suggests local referral and promotion practices
need investigation to ensure that women who would
benefit the most are linked to MWH services.
