African Journal of Public Health and Health Systems | 28 December 2010
Evaluating the Impact of Midwife-Led Maternity Waiting Homes on Skilled Birth Attendance in Rural Zambezi, Namibia: A 2010 Analysis
T, o, m, a, s, S, h, i, l, o, n, g, o, ,, N, d, a, p, e, w, a, H, a, m, u, n, y, e, l, a
Abstract
Geographical barriers in rural Namibia limit access to skilled birth attendance (SBA), contributing to high maternal mortality. Maternity waiting homes (MWHs) allow pregnant women to reside near health facilities before delivery. This paper evaluates an intervention in the Zambezi Region where MWHs were uniquely staffed and led by qualified midwives. This working paper analyses the impact of midwife-led maternity waiting homes on skilled birth attendance rates in remote villages of the Zambezi Region. It seeks to determine whether this model improved SBA rates compared to the period before its implementation. A retrospective, comparative analysis was conducted using routine health facility data. Skilled birth attendance rates from villages with access to the new midwife-led MWHs were compared to historical rates from the same villages prior to the intervention. Preliminary analysis indicates a positive association between the introduction of midwife-led MWHs and increased skilled birth attendance. A notable increase in SBA was observed in the catchment areas served by the homes compared to the pre-intervention period. Community engagement was identified as a key facilitating factor. The midwife-led model of maternity waiting homes appears to be a promising intervention for increasing skilled birth attendance in remote settings. It addresses both geographical and quality-of-care barriers to facility-based delivery. Further robust research, including a controlled study design, is needed to confirm causality. Policy consideration should be given to scaling up this model in similar remote contexts, with dedicated funding for midwife staffing and home maintenance. Maternal health, skilled birth attendance, maternity waiting homes, midwifery, rural health services, Namibia This analysis provides preliminary evidence on the operational model of midwife-led maternity waiting homes, contributing to the discourse on practical strategies to improve skilled birth attendance in geographically isolated communities.