Provider and client perspectives on the use of maternity waiting homes in rural Rwanda

BACKGROUND: The World Health Organization recommends the implementation of maternity waiting homes (MWH) to reduce delays in access to obstetric care, particularly for high-risk pregnancies and mothers living far from health facilities, and as a result, several countries have rolled out MWHs. However, Rwanda has not implemented this recommendation on a large scale. There is only one MWH in the country, hence a gap in knowledge regarding the potential utilisation and benefits of MWHs. OBJECTIVE: To explore providers' and clients' perspectives on facilitators and barriers to the use of MWH in rural Rwanda. METHODS: We conducted a qualitative study to explore health providers' and clients' perspectives on facilitators and barriers to the use of MWH in Rwanda, between December 2020 and January 2021. We used key informant interviews and focus group discussions to collect data. Data were analysed using NVivo qualitative analysis software version 11. RESULTS: Facilitators included perceptions that the MWH offered either a peaceful and home-like environment, good-quality services, or timely obstetric services, and was associated with good maternal and neonatal outcomes. Barriers included limited awareness of the MWH among pregnant women, fear of health providers to operate the MWH at full capacity, women's lack of autonomy, uncertainty over funding for the MWH, and perceived high user fees. CONCLUSION: The Ruli MWH offers a peaceful environment for pregnant women while providing quality and timely obstetric care, resulting in positive maternal and neonatal outcomes for women. However, its existence and benefits are not widely known, and its use is limited due to inadequate resources. There is a need for increased awareness of the MWH among healthcare providers and the community, and lessons from this MWH could inform the scale up of MWHs in Rwanda

Business · Economic growth · Environmental health · Health care · Maternity care · Rural area · Global Maternal and Child Health · Maternal and Perinatal Health Interventions · Medicine · Neonatal Respiratory Health Research · Nursing

• Every Newborn

  Open Access•Joy Elizabeth Lawn, Hannah Blencowe et al.•The Lancet•2014

  Incluir item

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  Open Access•Nancy Scott, Jeanette L Kaiser et al.•BMJ Global Health•2021

  Incluir item

• Temporal trends in coverage, quality and equity of maternal and child health services in Rwanda, 2000–2015

  Open Access•Celestin Hategeka, Catherine Arsenault et al.•BMJ Global Health•2020

  Incluir item

• Maternal and Perinatal Outcomes among Maternity Waiting Home Users and Non-Users in Rural Rwanda

  Open Access•Edwin Tayebwa, Richard Kalisa et al.•International Journal of…•2021

  Incluir item

• A systematic review and meta-analysis of the effectiveness of maternity waiting homes in low- and middle-income countries

  Open Access•Daphne N McRae, Nicole Bergen et al.•Health Policy and Planning•2021

  Incluir item

• Barriers to the use of maternity waiting homes in indigenous regions of Guatemala

  Marta Julia Ruiz, Marieke G van Dijk et al.•Culture Health & Sexuality•2013

  Incluir item