Faculty of Medicine, University of Groningen, Groningen, The Netherlands.
Department of Community Health and Epidemiology, University of Saskatchewan, Saskatoon, SK, Canada.
Reprod Health. 2023 Jul 5;20(1):101. doi: 10.1186/s12978-023-01615-x.
Maternity waiting homes (MHWs) are recommended to help bridge the geographical gap to accessing maternity services. This study aimed to provide an analysis of stakeholders' perspectives (women, families, communities and health workers) on the acceptability and feasibility of MWHs.
A qualitative evidence synthesis was conducted. Studies that were published between January 1990 and July 2020, containing qualitative data on the perspectives of the stakeholder groups were included. A combination of inductive and deductive coding and thematic synthesis was used to capture the main perspectives in a thematic framework.
Out of 4,532 papers that were found in the initial search, a total of 38 studies were included for the thematic analysis. Six themes emerged: (1) individual factors, such as perceived benefits, awareness and knowledge of the MWH; (2) interpersonal factors and domestic responsibilities, such as household and childcare responsibilities, decision-making processes and social support; (3) MWH characteristics, such as basic services and food provision, state of MWH infrastructure; (4) financial and geographical accessibility, such as transport availability, costs for MWH attendance and loss of income opportunity; (5) perceived quality of care in the MWH and the adjacent health facility, including regular check-ups by health workers and respectful care; and (6) Organization and advocacy, for example funding, community engagement, governmental involvement. The decision-making process of women and their families for using an MWH involves balancing out the gains and losses, associated with all six themes.
This systematic synthesis of qualitative literature provides in-depth insights of interrelating factors that influence acceptability and feasibility of MWHs according to different stakeholders. The findings highlight the potential of MWHs as important links in the maternal and neonatal health (MNH) care delivery system. The complexity and scope of these determinants of utilization underlines the need for MWH implementation strategy to be guided by context. Better documentation of MWH implementation, is needed to understand which type of MWH is most effective in which setting, and to ensure that those who most need the MWH will use it and receive quality services. These results can be of interest for stakeholders, implementers of health interventions, and governmental parties that are responsible for MNH policy development to implement acceptable and feasible MWHs that provide the greatest benefits for its users. Trial registration Systematic review registration number: PROSPERO 2020, CRD42020192219.
产房产前等候之家（Maternity waiting homes，MWHs）被推荐用于帮助弥合获取产妇服务的地理差距。本研究旨在分析利益相关者（妇女、家庭、社区和卫生工作者）对 MWH 的可接受性和可行性的观点。
进行了定性证据综合。纳入了 1990 年 1 月至 2020 年 7 月发表的包含利益相关者群体观点的定性数据的研究。采用归纳和演绎编码以及主题综合的组合方法，在主题框架中捕捉主要观点。
在最初搜索中发现的 4532 篇论文中，共有 38 项研究纳入了主题分析。出现了六个主题：（1）个人因素，例如对 MWH 的感知益处、意识和知识；（2）人际因素和家庭责任，例如家庭和儿童保育责任、决策过程和社会支持；（3）MWH 特征，例如基本服务和食物供应、MWH 基础设施状况；（4）财务和地理可达性，例如交通可用性、MWH 就诊费用和收入机会损失；（5）MWH 和附近卫生设施中感知的护理质量，包括卫生工作者的定期检查和尊重的护理；（6）组织和宣传，例如资金、社区参与、政府参与。妇女及其家庭使用 MWH 的决策过程涉及权衡与所有六个主题相关的得失。
本系统的定性文献综合提供了深入的见解，说明了影响 MWH 可接受性和可行性的相互关联因素。研究结果强调了 MWH 作为产妇和新生儿保健（MNH）护理提供系统中重要联系的潜力。这些决定因素的复杂性和范围强调了需要根据背景来指导 MWH 实施策略。需要更好地记录 MWH 的实施情况，以了解哪种类型的 MWH 在何种环境中最有效，并确保最需要 MWH 的人将使用它并获得高质量的服务。这些结果可能对利益相关者、卫生干预措施的实施者以及负责制定 MNH 政策的政府部门感兴趣，以实施能够为使用者带来最大利益的可接受和可行的 MWH。
PROSPERO 2020，CRD42020192219。
