Promoting access: the use of maternity waiting homes to achieve safe motherhood

Midwifery. 2013 Oct;29(10):1095-102. doi: 10.1016/j.midw.2013.07.020. Epub 2013 Aug 14.


Objective: to examine the structural and sociocultural factors influencing maternity waiting home (MWH) use through the lens of women, families, and communities in one rural county in postconflict Liberia.

Design: an exploratory, qualitative descriptive design using focus groups and in-depth, individual interviews was employed. Content analysis of data was performed using Penchansky and Thomas's (1981) five A's of access as a guiding framework.

Setting: rural communities in north-central Liberia.

Participants: a convenience sampling was used to recruit participants. Eight focus groups were held with 75 participants from congruent groups of (1) MWH users, (2) MWH non-users, (3) family members of MWH users, and (4) family members of MWH non-users. Eleven individual interviews were conducted with clinic staff or community leaders.

Findings: the availability of MWHs decreased the barrier of distance for women to access skilled care around the time of childbirth. Food insecurity while staying at a MWH was identified as a potential barrier by participants.

Key conclusions: examining access as a general concept within the specific dimensions of availability, accessibility, accommodation, affordability, and acceptability provides a way to describe the structural and sociocultural factors that influence access to a MWH and skilled attendance for birth.

Implications for practice: MWHs can address the barrier of distance in accessing skilled care for childbirth in a rural setting with long distances to a facility.

Keywords: Access; Maternity waiting homes; Midwifery; Safe motherhood.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adult
  • Consumer Behavior
  • Delivery of Health Care* / methods
  • Delivery of Health Care* / statistics & numerical data
  • Family / psychology*
  • Female
  • Focus Groups
  • Humans
  • Liberia
  • Maternal Health Services* / methods
  • Maternal Health Services* / statistics & numerical data
  • Needs Assessment
  • Patient Preference
  • Pregnancy
  • Pregnant Women / psychology*
  • Prenatal Care* / methods
  • Prenatal Care* / psychology
  • Prenatal Care* / statistics & numerical data
  • Rural Population