Utilization Of Maternity Waiting Home And Its Associated Factors Among Women Who Gave Birth In Pastoralists Community Of Elwaye District Borana Zone, Ethiopia

Abstract

Background: Maternity waiting home utilization is a valuable approach to enhance maternal and neonatal health services utilization among pastoralist women. However, there are a limited studies conducted to this end - regarding MWH utilizations and associated factors around the pastoralists localities in general and Elwaye district in particular. Objectives: To assess utilization of maternity waiting homes and its associated factors among women who gave birth in the last12 months in the pastoralist communities of Elwaye district, Borana zone, Ethiopia 2021. Methods: Concurrent mixed-method design was conducted from August 10-September 15, 2021. Cluster and purposive sampling techniques were used to select the study participants for quantitative and qualitative data respectively. Data were collected using a pre-tested structured questionnaires, focus group discussions and in-depth interviews. In multivariable logistic regression analysis, the level of statistical significance was declared at p-value <0.05 with 95% CI for AOR to identify significant factors. Qualitative data were thematically analyzed and integrated with quantitative information for interpretation of the findings. Results: The response rate was 622(97%). Only 13% (95% CI:10.5-15.6) of women had utilized MWHs. The women whose husbands had ever been involved in ANC (AOR=5.54, 95% CI=2.14-14.35), having caregivers at home (AOR=2.59,95% CI=1.14-5.86), having complications during pregnancy (AOR=3.06, 95% CI=1.32-7.10), attending pregnant women conferences(AOR=5.01, 95% CI=2.17-11.49), having a husband who received information about MWH (AOR=3.6,95%CI=1.54-8.49), transportation access (AOR=5.25, 95% CI=2.37-11.63), and favorable attitude towards MWH utilization(AOR=3.15, 95% CI=1.47-6.77) were factors positively associated with MWH utilization, whereas giving birth during the rainy season (AOR=0.35, 95% CI =0.15-0.81) and residing in the area within 10km from health center (AOR=0.15,95%CI=0.04-0.58) were negatively associated with MWH utilization. The barriers like norms, lack of decision making power among women, and lack of awareness were explored. Conclusion and Recommendations: The study found low utilization of maternity waiting homes in the study area. Lack of transportation access, norms, and limited awareness of MWH were found as a barriers of service utilization. Health promotion initiatives to raise awareness about the MWHs is importa