Factors associated with maternity waiting home use among women in Jimma Zone, Ethiopia: A multilevel cross-sectional analysis

Jaameeta Kurji, Lakew Abebe Gebretsadik, Muluemebet Abera Wordofa, Morankar Sudhakar, Yisalemush Asefa, Getachew Kiros, Abebe Mamo, Nicole Bergen, Shifera Asfaw, Kunuz Haji Bedru, Gebeyehu Bulcha, Ronald Labonte, Monica Taljaard, Manisha Kulkarni

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28 Citations (Scopus)


Objective To identify individual-, household- and community-level factors associated with maternity waiting home (MWH) use in Ethiopia. Design Cross-sectional analysis of baseline household survey data from an ongoing cluster-randomised controlled trial using multilevel analyses. Setting Twenty-four rural primary care facility catchment areas in Jimma Zone, Ethiopia. Participants 3784 women who had a pregnancy outcome (live birth, stillbirth, spontaneous/induced abortion) 12 months prior to September 2016. Outcome measure The primary outcome was self-reported MWH use for any pregnancy; hypothesised factors associated with MWH use included woman's education, woman's occupation, household wealth, involvement in health-related decision-making, companion support, travel time to health facility and community-levels of institutional births. Results Overall, 7% of women reported past MWH use. Housewives (OR: 1.74, 95% CI 1.20 to 2.52), women with companions for facility visits (OR: 2.15, 95% CI 1.44 to 3.23), wealthier households (fourth vs first quintile OR: 3.20, 95% CI 1.93 to 5.33) and those with no health facility nearby or living >30 min from a health facility (OR: 2.37, 95% CI 1.80 to 3.13) had significantly higher odds of MWH use. Education, decision-making autonomy and community-level institutional births were not significantly associated with MWH use. Conclusions Utilisation inequities exist; women with less wealth and companion support experienced more difficulties in accessing MWHs. Short duration of stay and failure to consider MWH as part of birth preparedness planning suggests local referral and promotion practices need investigation to ensure that women who would benefit the most are linked to MWH services.

Original languageEnglish
Article numbere028210
JournalBMJ open
Issue number8
Publication statusPublished or Issued - 1 Aug 2019
Externally publishedYes


  • community child health
  • epidemiology
  • ethiopia
  • institutional births
  • maternity waiting home
  • obstetrics

ASJC Scopus subject areas

  • Medicine(all)

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