Lori Jody R, Munro-Kramer Michelle L, Shifman Jordan, Amarah Patricia N M, Williams Garfee
J Midwifery Womens Health. 2017 Mar;62(2):163-171. doi: 10.1111/jmwh.12600. Epub 2017 Apr 4.
Liberia in West Africa has one of the highest maternal mortality ratios in the world (990/100,000 live births). Many women in Liberia live in rural, remote villages with little access to safe maternity services. The World Health Organization has identified maternity waiting homes (MWHs) as one strategy to minimize the barrier of distance in accessing a skilled birth attendant. However, limited data exist on satisfaction with MWHs or maternal health care in Liberia.
This mixed-methods case study examines women's satisfaction with their stay at a MWH and compares utilization rates before and during the Ebola outbreak. From 2012 to 2014, 650 women who stayed at one of 6 MWHs in rural Liberia during the perinatal or postnatal period were surveyed. Additionally, 60 semi-structured interviews were conducted with traditional providers, skilled birth attendants, and women utilizing the MWHs. Quantitative analyses assessed satisfaction rates before and during the Ebola outbreak. Content analysis of semi-structured interviews supplemented the quantitative data and provided a lens into the elements of satisfaction with the MWHs.
The majority of women who utilized the MWHs stated they would suggest the MWH to a friend or relative who was pregnant (99.5%), and nearly all would utilize the home again (98.8%). Although satisfaction with the MWHs significantly decreased during the Ebola outbreak (P < .001), participants were satisfied overall with the MWHs. Content analysis identified areas of satisfaction that encompassed the themes of restful and supportive environment as well as areas for improvement such as lacking necessary resources and loneliness.
This case study demonstrated that women using MWHs in Bong County, Liberia are generally satisfied with their experience and plan to use an MWH again during future pregnancies to access a skilled birth attendant for birth. Women are also willing to encourage family and friends to use MWHs.
西非的利比里亚是世界上孕产妇死亡率最高的国家之一（每10万例活产中有990例死亡）。利比里亚的许多妇女生活在农村偏远村庄，几乎无法获得安全的孕产妇服务。世界卫生组织已将孕产妇候产之家（MWHs）确定为一种策略，以尽量减少距离障碍，使妇女能够获得熟练的助产服务。然而，关于利比里亚对孕产妇候产之家或孕产妇保健的满意度的数据有限。
本混合方法案例研究考察了妇女对在孕产妇候产之家停留的满意度，并比较了埃博拉疫情爆发前和期间的使用率。2012年至2014年，对在利比里亚农村6个孕产妇候产之家中的一个度过围产期或产后阶段的650名妇女进行了调查。此外，还对传统医疗服务提供者、熟练的助产人员以及使用孕产妇候产之家的妇女进行了60次半结构化访谈。定量分析评估了埃博拉疫情爆发前和期间的满意度。对半结构化访谈的内容分析补充了定量数据，并提供了一个了解对孕产妇候产之家满意度要素的视角。
使用孕产妇候产之家的大多数妇女表示，她们会向怀孕的朋友或亲戚推荐该孕产妇候产之家（99.5%），几乎所有人都愿意再次使用该候产之家（98.8%）。尽管在埃博拉疫情爆发期间对孕产妇候产之家的满意度显著下降（P <.001），但参与者总体上对孕产妇候产之家感到满意。内容分析确定了满意度的领域，包括宁静和支持性环境等主题，以及需要改进的领域，如缺乏必要资源和孤独感。
本案例研究表明，在利比里亚邦县使用孕产妇候产之家的妇女总体上对她们的经历感到满意，并计划在未来怀孕时再次使用孕产妇候产之家，以便获得熟练的助产服务。妇女也愿意鼓励家人和朋友使用孕产妇候产之家。
