A Policy Discussion on Maternity Waiting Home in Zambia to Achieve Its Vision 2030 on Maternal and Perinatal Mortality

Maternal and child health, with a focus on perinatal health, remains an area of focus for developing countries. Zambia has identified maternal and child health as an area of concentration in its 2030 vision agenda, with the goal of achieving less than 180 maternal deaths per 100, 000 live births by 2030. So far, interventions executed by the government include improving birthing space and providing higher quality services such as emergency obstetric care, post-abortion care and encouraging community level advocacy by safe motherhood action groups. However, the high perinatal and maternal mortality rate in Zambia is associated with the low accessibility to quality obstetric care as a result of delays in decision to seek care, delays in reaching care centers, and delays in receiving care. Consequently, Maternal Waiting Homes (MWH) has been identified as a tool for reducing maternal and perinatal mortality. It is currently being used in Zambia but there is limited data on the operation and its impact. The evidence on MWH for this paper was based on the aggregate review of numerous studies. These identified MWH as an effective, equitable and cost-effective intervention but without concrete evidence of its acceptance. The effectiveness is highly dependent on its strength to promptly identify and refer high-risk pregnant women to skilled obstetric care. In addition, other non-medical interventions including strengthening family planning program at the grassroots level and integration of community mobilization in the MWH program with service quality improvement were recognized as successful. However, the utilization of MWHS has been low in most low- and middle-income countries (LMICs). This paper also describes potential implications of the MWHs on the political, economic, and social and development sectors of the country. In all, it recommends the upgrading and strengthening of MWH and its health system in Zambia, alongside integration of other suggested interventions.