ArticleBMJ open2022
Barriers and facilitators to facility-based delivery in rural Zambia: a qualitative study of women's perceptions after implementation of an improved maternity waiting homes intervention.
Article in BMJ open, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02620436 (Increasing Equitable Access to Safe Deliveries in Zambia), which is not on this map. Cited by 8 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
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Increasing Equitable Access to Safe Deliveries in Zambia
Who cites it
8 citing papers in PubMed, 10 citations in OpenAlex.
- Article
- From knowledge to action: understanding midwives' challenges in implementing delayed cord clamping in Northern Ghana.Maternal health, neonatology and perinatology · 2026Article
- Access to malaria diagnosis and treatment in Zambia in the context of scaling-up community case management: Results from repeated national cross-sectional surveys.PLOS global public health · 2026Article
- Qualitative application of the diffusion of innovation theory to maternity waiting homes in rural Zambia.Implementation science communications · 2025Article
- Community boat service to promote institutional delivery in the Philippines: a mixed-methods study of a social innovation.BMJ public health · 2024Article
- Maternal mortality in Eastern Democratic Republic of Congo: a 10-year multi-zonal institutional death review.BMC public health · 2024Article
- Perspectives of pregnant women on the utilisation of a maternity waiting home near Onandjokwe Lutheran Hospital in Oshikoto Region, Namibia.South African family practice : official journal of the South African Academy of Family Practice/Primary Care · 2024Article
- Article
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Authors and funding
15 authors at 7 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesWomen in sub-Saharan Africa face well-documented barriers to facility-based deliveries. An improved maternity waiting homes (MWH) model was implemented in rural Zambia to bring pregnant women closer to facilities for delivery. We qualitatively assessed whether MWHs changed perceived barriers to facility delivery among remote-living women.
designWe administered in-depth interviews (IDIs) to a randomly selected subsample of women in intervention (n=78) and control (n=80) groups who participated in the primary quasi-experimental evaluation of an improved MWH model. The IDIs explored perceptions and preferences of delivery location. We conducted content analysis to understand perceived barriers and facilitators to facility delivery. SETTING AND
participantsParticipants lived in villages 10+ km from the health facility and had delivered a baby in the previous 12 months.
interventionThe improved MWH model was implemented at 20 rural health facilities.
resultsOver 96% of participants in the intervention arm and 90% in the control arm delivered their last baby at a health facility. Key barriers to facility delivery were distance and transportation, and costs associated with delivery. Facilitators included no user fees, penalties for home delivery, desire for safe delivery and availability of MWHs. Most themes were similar between study arms. Both discussed the role MWHs have in improving access to facility-based delivery. Intervention arm participants expressed that the improved MWH model encourages use and helps overcome the distance barrier. Control arm participants either expressed a desire for an improved MWH model or did not consider it in their decision making.
conclusionsEven in areas with high facility-based delivery rates in rural Zambia, barriers to access persist. MWHs may be useful to address the distance challenge, but no single intervention is likely to address all barriers experienced by rural, low-resourced populations. MWHs should be considered in a broader systems approach to improving access in remote areas. TRIAL REGISTRATION NUMBER: NCT02620436.
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