Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2012 Oct 17;10(10):CD006759.
doi: 10.1002/14651858.CD006759.pub3.

Maternity waiting facilities for improving maternal and neonatal outcome in low-resource countries

Affiliations

Maternity waiting facilities for improving maternal and neonatal outcome in low-resource countries

Luc van Lonkhuijzen et al. Cochrane Database Syst Rev. .

Abstract

Background: A maternity waiting home (MWH) is a facility within easy reach of a hospital or health centre which provides emergency obstetric care (EmOC). Women may stay in the MWH at the end of their pregnancy and await labour. Once labour starts, women move to the health facility so that labour and giving birth can be assisted by a skilled birth attendant. The aim of the MWH is to improve accessibility to skilled care and thus reduce morbidity and mortality for mother and neonate should complications arise. Some studies report a favourable effect on the outcomes for women and their newborns. Others show that utilisation is low and barriers exist. However, these data are limited in their reliability.

Objectives: To assess the effects of a maternity waiting facility on maternal and perinatal health.

Search methods: We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (27 January 2012), CENTRAL (The Cochrane Library 2011, Issue 4 of 4), MEDLINE (1966 to January 2012), EMBASE (1980 to January 2012), CINAHL (1982 to January 2012), African Journals Online (AJOL) (January 2012), POPLINE (January 2012), Dissertation Abstracts (January 2012) and reference lists of retrieved papers.

Selection criteria: Randomised controlled trials including quasi-randomised and cluster-randomised trials that compared perinatal and maternal outcome in women using a MWH and women who did not.

Data collection and analysis: There were no randomised controlled trials or cluster-randomised trials identified from the search.

Main results: There were no randomised controlled trials or cluster-randomised trials identified from the search.

Authors' conclusions: There is insufficient evidence to determine the effectiveness of maternity waiting facilities for improving maternal and neonatal outcomes.

PubMed Disclaimer

Conflict of interest statement

None known.

Update of

References

References to studies excluded from this review

Andemichael 2009 {published data only}
    1. Andemichael G, Haile B, Kosia A, Mufunda J. Maternity waiting homes: A panacea for maternal/neonatal conundrums in Eritrea. Journal of the Eritrean Medical Association JEMA 2009;4(1):18‐21.
Chandramohan 1994 {published data only}
    1. Chandramohan D, Cutts F, Chandra R. Effects of a maternity waiting home on adverse maternal outcomes and the validity of antenatal risk screening. International Journal of Gynecology & Obstetrics 1994;46(3):279‐84. - PubMed
Chandramohan 1995 {published data only}
    1. Chandramohan D, Cutts F, Millard P. The effect of stay in a maternity waiting home on perinatal mortality in rural Zimbabwe. Journal of Tropical Medicine and Hygiene 1995;98(4):261‐7. - PubMed
Kelly 2010 {published data only}
    1. Kelly K, Kohls E, Poovan P, Schiffer R, Redito A, Winter H, MacArthur C. The role of a maternity waiting area (MWA) in reducing maternal mortality and stillbirths in high‐risk women in rural Ethiopia. BJOG: an international journal of obstetrics and gynaecology 2010;117(11):1377‐83. - PubMed
Millard 1991 {published data only}
    1. Millard P, Bailey J, Hanson J. Antenatal village stay and pregnancy outcome in rural Zimbabwe. Central African Journal of Medicine 1991;37:1‐4. - PubMed
Spaans 1998 {published data only}
    1. Spaans WA, Roosmalen J, Wiechen CMAG. A maternity waiting home experience in Zimbabwe. International Journal of Gynecology & Obstetrics 1998;61(2):179‐80. - PubMed
Tumwine 1996 {published data only}
    1. Tumwine JK, Dungare PS. Maternity waiting shelters and pregnancy outcome: experience from a rural area in Zimbabwe. Annals of Tropical Paediatrics 1996;16:55‐9. - PubMed
van Lonkhuijzen 2003 {published data only}
    1. Lonkhuijzen L, Stegeman M, Nyirongo R, Roosmalen J. Use of maternity waiting home in rural Zambia. African Journal of Reproductive Health 2003;7(1):32‐6. - PubMed
Wild 2012 {published data only}
    1. Wild K, Barclay L, Kelly P. Martins N. The tyranny of distance: maternity waiting homes and access to birthing facilities in rural Timor‐Leste. Bulletin of the World Health Organization 2012;90:97‐103. - PMC - PubMed

Additional references

AbouZahr 1998
    1. AbouZahr C. Improving access to quality maternal health services. Planned Parenthood Challenges 1998, (1):6‐9. - PubMed
Barss 1985
    1. Barss P, Blackford C. Grand multiparity: benefits of a referral program for hospital delivery and postpartum tubal ligation. Papua New Guinea Medical Journal 1985;28:35‐9. - PubMed
Bulatao 2003
    1. Bulatao RA, Ross JA. Which health services reduce maternal mortality? Evidence from ratings of maternal health services. Tropical Medicine and International Health 2003;8:720‐1. - PubMed
Cardoso 1986
    1. Cardoso UF. Giving birth is safer now. World Health Forum 1986;7:348‐52.
Danel 2004
    1. Danel I, Rivera A. Honduras, 1990‐1997. In: Koblinsky MA editor(s). Reducing Maternal Mortality. Learning from Bolivia, China, Egypt, Honduras, Indonesia, Jamaica and Zimbabwe. World Bank Publications, 2004:51‐62.
Eckermann 2008
    1. Eckermann E, Deodato G. Maternity waiting homes in Southern Lao PDR: the unique 'silk home'. Journal of Obstetrics & Gynaecology Research 2008;34(5):767‐75. - PubMed
Essex 1977
    1. Essex BJ, Everett VJ. Use of an action‐orientated record for antenatal screening. Tropical Doctor 1977;7:134‐8. - PubMed
Fawcus 1996
    1. Fawcus S, Mbizvo M, Lindmark G, Nystrom L. A community‐based investigation of avoidable factors for maternal mortality in Zimbabwe. Studies in Family Planning 1996;27(6):319‐27. - PubMed
Feresu 2003
    1. Feresu S, Nyandoro M, Mumbwanda L. Zimbabwe, 1980‐2000. In: Koblinsky MA editor(s). Reducing Maternal Mortality. Learning from Bolivia, China, Egypt, Honduras, Indonesia, Jamaica and Zimbabwe. World Bank Publisher, 2003:63‐80.
Fraser 2008
    1. Fraser B. Peru makes progress on maternal health. Lancet 2008;371:1233‐4. - PubMed
Greenwood 1987
    1. Greenwood AM, Greenwood BM, Bradley AK, Williams K, Shenton FC, Tulloch S, et al. A prospective survey of the outcome of pregnancy in a rural area of the Gambia. Bulletin of the World Health Organization 1987;65:635‐43. - PMC - PubMed
Higgins 2011
    1. Higgins JPT, Green S, editors. Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [updated March 2011]. The Cochrane Collaboration, 2011. Available from www.cochrane‐handbook.org.
Hill 2005
    1. Hill K, AbouZhar C, Wardlaw T. Estimates of maternal mortality worldwide between 1990 and 2005: an assessment of available data. Lancet 2007;370(9595):1311‐9. - PubMed
Jahn 1998
    1. Jahn A, Kowalewski M, Kimatta SS. Obstetric care in southern Tanzania: does it reach those in need?. Tropical Medicine and International Health 1998;3:926‐32. - PubMed
Kambarami 1999
    1. Kambarami RA, Chirenje MZ, Rusakaniko S. Antenatal care patterns and factors associated with perinatal outcome in two rural districts in Zimbabwe. Central African Journal of Medicine 1999;45(11):294‐9. - PubMed
Khan 2006
    1. Khan KS, Wojdyla D, Say L, Gulmezoglu AM, Look PF. WHO analysis of causes of maternal death: a systematic review. Lancet 2006;367:1066‐74. - PubMed
Knowles 1988
    1. Knowles JK. A shelter that saves mothers' lives. World Health Forum 1988;9:387‐8. - PubMed
LaGuardia 1989
    1. LaGuardia KD, Druzin ML, Eades C. Maternity shelter care for adolescents: Its effect on incidence of low birth weight. American Journal of Obstetrics and Gynecology 1989;161(2):303‐6. - PubMed
Larsen 1978
    1. Larsen JV, Muller EJ. Obstetric care in a rural population. South African Medical Journal 1978;54:1137‐40. - PubMed
Lennox 1984
    1. Lennox CE. Assessment of obstetric high risk factors in a developing country. Tropical Doctor 1984;14:125‐9. - PubMed
Mahony 1995
    1. Mahony O, Steinberg M. Population‐based survey of obstetric practices among rural women in the Bizana district, Transkei. South African Medical Journal 1995;85(11):1168‐71. - PubMed
Martey 1995
    1. Martey JO, Djan JO, Twum S, Browne ENL, Opoku SA. Utilization of Maternal Health Services in Ejisu District, Ghana. West African Journal of Medicine 1995;14(1):24‐8. - PubMed
Mramba 2010
    1. Mramba L, Nassir FA, Ondieki C, Kimanga D. Reasons for low utilization of a maternity waiting home in rural Kenya. International Journal of Gynecology & Obstetrics 2010;108(2):152‐3. - PubMed
Nhindiri 1996
    1. Nhindiri P, Munjanja S, Zhanda I, Lindmark G, Nystrom L. A community‐based study on utilisation of maternity services in rural Zimbabwe. African Journal of Health Science 1996;3(4):120‐5. - PubMed
Poovan 1990
    1. Poovan P, Kifle F, Kwast BE. A maternity waiting home reduces obstetric catastrophes. World Health Forum 1990;11(4):440‐6. - PubMed
RevMan 2011 [Computer program]
    1. The Nordic Cochrane Centre, The Cochrane Collaboration. Review Manager (RevMan). Version 5.1. Copenhagen: The Nordic Cochrane Centre, The Cochrane Collaboration, 2011.
Sambe 1990
    1. Sambe D. Karawa Health Zone, Zaire. In: Rooks J, Winikoff B editor(s). A Reassessment of the Concept of Reproductive Risk in Maternity Care and Family Planning Services. New York: The Population Council, 1990:72‐8.
Stewart 1968
    1. Stewart DB, Lawson JB. The organisation of obstetric services. In: Lawson JB, Stewart DB editor(s). Obstetrics and Gynaecology in the Tropics and Developing Countries. London: Edward Arnold, 1968:305‐12.
Thaddeus 1994
    1. Thaddeus S, Maine D. Too far to walk: maternal mortality in context. Social Science and Medicine 1994;38:1091‐110. - PubMed
Touray‐Daffeh 2003
    1. Touray‐Daffeh F, Lungu K, Ashwood‐Smith H, Bokosi M, Ratsma E. Perceptions, utilisation and quality of care in Maternity Waiting Huts in Southern Malawi. Safe Motherhood. Operations Research and Participatory Needs Assessments (1998‐2002). Project Management Unit, 2003:20.
Van den Heuvel 1999
    1. Heuvel OA, Mey WG, Buddingh H, Bots ML. Use of maternal care in a rural area of Zimbabwe: a population‐based study. Acta Obstetricia et Gynecologica Scandinavica 1999;78(10):838‐46. - PubMed
Wessel 1990
    1. Wessel L. Maternity waiting homes. Casa Materna brings care to rural women in northern Nicaragua. Maternal Mortality and Morbidity: a Call to Women for Action. Amsterdam: Women's Global Network for Reproductive Rights, 1990:40‐1.
WHO 1991
    1. World Health Organization. Essential Elements of Obstetric Care at First Referral Level. Geneva: WHO, 1991.
WHO 1994
    1. World Health Organization. Indicators to Monitor Maternal Health Goals ‐ Report of a Technical Working Group. Geneva: WHO, 1994.
WHO 2004
    1. World Health Organization. Making Pregnancy Safer: the Critical Role of the Skilled Attendant: a Joint Statement by WHO, ICM and FIGO. Geneva: WHO, 2004.
Wilson 1997
    1. Wilson JB, Collison AHK, Richardson D, Kwofie G, Senah KA, Tinkorang EK. The maternity waiting home concept: the Nsawam, Ghana experience. The Accra PMM Team. International Journal of Gynecology & Obstetrics 1997;59 Suppl 2:S165‐S172. - PubMed

Publication types

LinkOut - more resources