The use of maternity waiting homes at Chiradzulu District Hospital, Southern Malawi
The concept of maternity waiting home (MWH) was introduced at Chiradzulu District Hospital in 2012, in an effort to improve maternal and neonatal health in Chiradzulu District through the promotion of skilled attendance at birth in the district. Since then, no study has been conducted to examine the use of MWH at the district hospital. This comparative study was designed to examine the use of MWH at Chiradzulu District Hospital, Southern Malawi by identifying the characteristics of pregnant women who use MWH; identifying factors that influenced use of MWH; describing types of services offered at MWH, and comparing pregnancy outcomes of women who used MWH with those who did not use MWH. A comparative cross sectional study was conducted at Chiradzulu District Hospital, postnatal ward. Using a proportionate stratified random sampling method, a total 266 postnatal mothers were enrolled. The study had two strata-one stratum comprised mothers who used MWH and the other stratum comprised mothers who did not use MWH, but came direct from home to deliver at the district hospital. Systematic random sampling method was used to select the 133 participants in each stratum. Data collection was done using a well structured questionnaire through face to face interviews and review of participant’s records. Data was analysed quantitatively using SPSS version 16.0. Chi-square test at 5% level of significance was used to determine associations as well as to compare pregnancy outcomes between mothers who used MWH and those who did not use MWH. There was no significant difference in demographic attributes between mothers who used MWH and those who did not use MWH (P≥0.050). However, significant difference was identified on the following obstetric risk factors: malaria in pregnancy (p=0.030), severe anaemia in pregnancy (p=0.014), and breech presentation (p=0.042) between mothers who used MWH and those who did not use MWH. Furthermore, the study shows that there was no significant association between the utilisation of MWH and the pregnancy outcomes (p≥0.050). The only significant difference was on babies with very low Apgar score of 0-3 at five minutes (p=0.035); only one baby born to mothers who used MWH had severe asphyxia (Apgar score of ≤ 3) compared to seven babies born to mothers who did not use MWH. Although the results showed that MWH utilisation at Chiradzulu District Hospital, Southern Malawi did not significantly improve maternal and neonatal health outcomes; babies born to mothers who used MWH were more likely to survive the neonatal period.