Policies & Procedures
Involvement of researchers, government, and non-governmental organizations is needed for the adoption of maternity waiting homes (MWHs) as a health system strengthening strategy. Operational guidelines and strengthening of high quality obstetrical services with clear linkages to a range of support services offered and transfer to the next level of care provide the basis for MWHs as a successful intervention to increase facility delivery and improve maternal and newborn outcomes. Continuous engagement with district and central government is crucial for the on-going management and financial support required to complement local management. Rigorous data and evaluation of MWHs and their impact on health outcomes for mothers and newborns help support the development of public policies related to adoption of MWHs.
Example Operational Guidelines
National Guideline on Maternity Waiting Home, Cambodia https://www.yumpu.com/en/document/read/36645875/guideline-on-maternity-waiting-home-ministry-of-health
Example Policies
The Ministry of Health and Social Welfare, Republic of Liberia listed maternity waiting homes as an essential standard of the health system infrastructure Standards for Health Infrastructure (2013). http://pdf.usaid.gov/pdf_docs/PA00KBK4.pdf
Supporting Facilities (6.1.J.) Maternal waiting homes are required at all new PHC 2s and Health Centers, and are strongly recommended at existing PHC 2s and Health Centers
Supporting Facilities (7.3.A.) Maternal waiting homes must be prioritized in locations where there are facilities that are well-equipped and staffed to handle deliveries, and serve communities that live relatively long walking distances (>10km) from the facility
The Liberia Critical Humanitarian Gaps (2013) analysis prioritized MWHs as a strategy to strengthen community based reproductive health services and increase skilled institutional delivery. https://www.humanitarianlibrary.org/sites/default/files/2013/07/LIBERIA_CHG_2013.pdf
Develop strategies to strengthen community based reproductive health services to increase skilled institutional deliveries
1. In collaboration with the county health teams and partners define adequate result-based strategies to implement community based activities that enhance access and utilization of Reproductive health services including GBV and HIV prevention services by targeted populations
2. In collaboration with county health teams identify training needs for staff and community health volunteers in the provision of MISP of RH services at community level
3. Use existing data to develop strategies to encourage institutional deliveries by the target population
4. Strengthen Maternal Waiting homes to encourage institutional deliveries.
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*denotes open access
Fraser B. Peru makes progress on maternal health. The Lancet. 2008;371:1233-1234.
*Gorry C. Cuban maternity homes: A model to address at-risk pregnancy. MEDICC Review. 2011;13(3):12-15. doi:10.37757/MR2011V13.N3.4
*Idris IO, Araoye D, Chijioke OD, Gavkalova N. A policy discussion on maternity waiting homes in Zambia to achieve its vision 2030 on maternal and perinatal mortality. Journal of Family Medicine and Health Care, 2020;6(1):1-7. doi:10.11648/j.jfmhc.20200601.11
*Lori JR, Perosky JE, Rominski S, Munro-Kramer ML, Cooper F, Kofa A, Nyanplu A, James KH, Cole GG, Coley K, Liu H, Moyer CA. Maternity waiting homes in Liberia: results of a countrywide multi-sector scale-up. PlosOne. 2020;15(6):e0234785.
Prado AG, Cortez R. Maternity waiting homes and institutional birth in Nicaragua: policy options and strategic implications. International Journal of Health Planning and Management. 2011;27(2):150-166. doi:10.1002/hpm.1107.