Effectiveness of Maternity Waiting Areas in Improving Access to Obstetric Care

Most maternal deaths that occur in sub Saharan Africa are due to conditions that are preventable through timely detection and management at health facilities. In Ethiopia, only 15% of women gave birth at health facilities in 2014. Large distances to health facilities, prohibitive transport costs, low decision-making power among women and poor awareness about risks were some of the reasons for low service utilization. Women often delay accessing services when complications arise or they are already in labour. Maternity waiting areas provide women a temporary residence near health facilities as they await their due date. They can be monitored by midwives, engage in group activities and rest before delivery. Coupled with community education, these spaces have the potential to improve women's access to timely obstetric care. Currently, most evidence about the potential benefit of these shelters comes from observational studies which are often influenced by factors other than those under investigation. A trial is being conducted in Jimma Zone, Ethiopia to understand what influences use of maternal health care services and how effective maternity waiting areas and community education are in improving coverage of services. The trial will facilitate the adoption of evidence-based policies around maternity waiting areas and related community education.