Maternity waiting Home-use and associated factors among mothers in northwest Ethiopia, The application of the integrated behavioral model

Abstract

Background: Maternal mortality in Ethiopia is the highest in the world (412/100,000). Health facility delivery is the cornerstone in reducing maternal mortality. However, health facility delivery is low in Ethiopia, due to poor access and ill-equipped health facilities. Maternity waiting home (MWH) is one of the comprehensive packages of essential obstetric services, enabling women to access well-equipped health facilities. However, there are limited studies on maternal waiting home use in Ethiopia. This study aimed to use the integrated behavioral model, to assess maternal waiting home use and associated factors among mothers in the East Bellessa district, northwest Ethiopia.
Method: A community-based cross-sectional study was conducted from the 1-27 of March 2020. The multistage sampling technique was used to select a total of 624 mothers. Data was collected using the face-to-face interview technique. The reliability and validity of the items were checked using exploratory factor analysis. Multivariable logistic regressions were conducted to identify the factors associated with maternal waiting home use. Findings with a p-value <0.05 with a 95% confidence interval were considered statistically significant in the final model.
Result: Overall, 20.5% (95% CI=17.3-23.7) of mothers used maternity waiting homes for the index of childbirth. Husband educational status (AOR=3.78, CI =1.44-9.93), the knowledge on maternity waiting homes (AOR=3.97, CI=2.27-6.95), between 2 and 3 antenatal care follow ups (AOR=0.14 CI=0.06-0.31), experiential attitude (AOR=2.37, CI=1.64-3.44), descriptive norms (AOR=0.66, CI=0.47-0.94), perceived behavioral control (AOR=1.07, CI=1.02-1.13) and behavioral intention (AOR=1.37, CI=1.1-1.71) were associated with maternity waiting home use.
Conclusion: Maternity waiting home utilization was low. Husband’s education status, antenatal care follow-up, knowledge on maternal waiting homes, experiential attitude, descriptive norms, perceived behavioral control and behavioral intention were positively significantly associated with MWH utilization. Therefore, strengthening the use antenatal care services, husbands’ education, and developing a positive attitude towards MWH may improve the use of maternity waiting homes among women.