Increasing facility delivery through maternity waiting homes for women living far from a health facility in rural Zambia: a quasi-experimental study.

Autor: Lori JR; University of Michigan School of Nursing, Ann Arbor, MI, USA., Munro-Kramer ML; University of Michigan School of Nursing, Ann Arbor, MI, USA., Liu H; University of Michigan School of Nursing, Ann Arbor, MI, USA., McGlasson KL; Boston University School of Public Health, Boston, MA, USA., Zhang X; University of Michigan School of Nursing, Ann Arbor, MI, USA., Lee H; University of Michigan School of Nursing, Ann Arbor, MI, USA., Ngoma T; Zambia Centre for Applied Health Research and Development, Lusaka, Zambia., Kaiser JL; Boston University School of Public Health, Boston, MA, USA., Bwalya M; Zambia Centre for Applied Health Research and Development, Lusaka, Zambia., Musonda G; Africare/Zambia, Lusaka, Zambia., Sakala I; Africare/Zambia, Lusaka, Zambia., Perosky JE; University of Michigan School of Nursing, Ann Arbor, MI, USA., Fong RM; Boston University School of Public Health, Boston, MA, USA., Boyd CJ; University of Michigan School of Nursing, Ann Arbor, MI, USA., Chastain P; Boston University School of Public Health, Boston, MA, USA., Rockers PC; Boston University School of Public Health, Boston, MA, USA., Hamer DH; Boston University School of Public Health, Boston, MA, USA., Biemba G; Paediatric Centre of Excellence, National Health Research Authority, Lusaka, Zambia., Vian T; Boston University School of Public Health, Boston, MA, USA., Bonawitz R; Boston University School of Public Health, Boston, MA, USA., Lockhart N; University of Michigan School of Nursing, Ann Arbor, MI, USA., Scott NA; Boston University School of Public Health, Boston, MA, USA.
Jazyk: angličtina
Zdroj: BJOG : an international journal of obstetrics and gynaecology [BJOG] 2021 Oct; Vol. 128 (11), pp. 1804-1812. Date of Electronic Publication: 2021 Jun 08.
DOI: 10.1111/1471-0528.16755
Abstrakt: Objective: To report on the effectiveness of a standardised core Maternity Waiting Home (MWH) model to increase facility deliveries among women living >10 km from a health facility.
Design: Quasi-experimental design with partial randomisation at the cluster level.
Setting: Seven rural districts in Zambia.
Population: Women delivering at 40 health facilities between June 2016 and August 2018.
Methods: Twenty intervention and 20 comparison sites were used to test whether MWHs increased facility delivery for women living in rural Zambia. Difference-in-differences (DID) methodology was used to examine the effectiveness of the core MWH model on our identified outcomes.
Main Outcome Measures: Differences in the change from baseline to study period in the percentage of women living >10 km from a health facility who: (1) delivered at the health facility, (2) attended a postnatal care (PNC) visit and (3) were referred to a higher-level health facility between intervention and comparison group.
Results: We detected a significant difference in the percentage of deliveries at intervention facilities with the core MWH model for all women living >10 km away (DID 4.2%, 95% CI 0.6-7.6, P = 0.03), adolescent women (<18 years) living >10 km away (DID 18.1%, 95% CI 6.3-29.8, P = 0.002) and primigravida women living >10 km away (DID 9.3%, 95% CI 2.4-16.4, P = 0.01) and for women attending the first PNC visit (DID 17.8%, 95% CI 7.7-28, P < 0.001).
Conclusion: The core MWH model was successful in increasing rates of facility delivery for women living >10 km from a healthcare facility, including adolescent women and primigravidas and attendance at the first PNC visit.
Tweetable Abstract: A core MWH model increased facility delivery for women living >10 km from a health facility including adolescents and primigravidas in Zambia.
(© 2021 The Authors. BJOG: An International Journal of Obstetrics and Gynaecology published by John Wiley & Sons Ltd.)
Databáze: MEDLINE
Externí odkaz: