Lori J R, Munro-Kramer M L, Liu H, McGlasson K L, Zhang X, Lee H, Ngoma T, Kaiser J L, Bwalya M, Musonda G, Sakala I, Perosky J E, Fong R M, Boyd C J, Chastain P, Rockers P C, Hamer D H, Biemba G, Vian T, Bonawitz R, Lockhart N, Scott N A
University of Michigan School of Nursing, Ann Arbor, MI, USA.
Boston University School of Public Health, Boston, MA, USA.
BJOG. 2021 Oct;128(11):1804-1812. doi: 10.1111/1471-0528.16755. Epub 2021 Jun 8.
To report on the effectiveness of a standardised core Maternity Waiting Home (MWH) model to increase facility deliveries among women living >10 km from a health facility.
Quasi-experimental design with partial randomisation at the cluster level.
Seven rural districts in Zambia.
Women delivering at 40 health facilities between June 2016 and August 2018.
Twenty intervention and 20 comparison sites were used to test whether MWHs increased facility delivery for women living in rural Zambia. Difference-in-differences (DID) methodology was used to examine the effectiveness of the core MWH model on our identified outcomes.
Differences in the change from baseline to study period in the percentage of women living >10 km from a health facility who: (1) delivered at the health facility, (2) attended a postnatal care (PNC) visit and (3) were referred to a higher-level health facility between intervention and comparison group.
We detected a significant difference in the percentage of deliveries at intervention facilities with the core MWH model for all women living >10 km away (DID 4.2%, 95% CI 0.6-7.6, P = 0.03), adolescent women (<18 years) living >10 km away (DID 18.1%, 95% CI 6.3-29.8, P = 0.002) and primigravida women living >10 km away (DID 9.3%, 95% CI 2.4-16.4, P = 0.01) and for women attending the first PNC visit (DID 17.8%, 95% CI 7.7-28, P < 0.001).
The core MWH model was successful in increasing rates of facility delivery for women living >10 km from a healthcare facility, including adolescent women and primigravidas and attendance at the first PNC visit.
A core MWH model increased facility delivery for women living >10 km from a health facility including adolescents and primigravidas in Zambia.
报告标准化核心产妇候产之家（MWH）模式在提高居住在距离医疗机构10公里以上的妇女在医疗机构分娩率方面的有效性。
整群水平部分随机化的准实验设计。
赞比亚的7个农村地区。
2016年6月至2018年8月期间在40家医疗机构分娩的妇女。
使用20个干预点和20个对照点来测试产妇候产之家是否提高了赞比亚农村妇女在医疗机构的分娩率。采用差分法（DID）来检验核心产妇候产之家模式对我们确定的结果的有效性。
居住在距离医疗机构10公里以上的妇女中，干预组和对照组在从基线到研究期间在以下方面的变化差异：（1）在医疗机构分娩的比例；（2）接受产后护理（PNC）访视的比例；（3）被转诊到上级医疗机构的比例。
我们发现，对于所有居住在10公里以外的妇女（DID 4.2%，95%CI 0.6-7.6，P=0.03）、居住在10公里以外的青少年妇女（<18岁）（DID 18.1%，95%CI 6.3-29.8，P=0.002）和居住在10公里以外的初产妇（DID 9.3%，95%CI 2.4-16.4，P=0.01），以及接受首次产后护理访视的妇女（DID 17.8%，95%CI 7.7-28，P<0.001），采用核心产妇候产之家模式的干预机构的分娩比例存在显著差异。
核心产妇候产之家模式成功提高了居住在距离医疗机构10公里以上的妇女的医疗机构分娩率，包括青少年妇女和初产妇，以及首次产后护理访视的参与率。
核心产妇候产之家模式提高了居住在距离医疗机构10公里以上的妇女的医疗机构分娩率，包括赞比亚的青少年妇女和初产妇。
