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Table 1 General characteristics of included studies

From: Understanding the implementation of maternity waiting homes in low- and middle-income countries: a qualitative thematic synthesis

Title Study Design Setting Scale2 Description of Intervention
Ande-michael et al. (2009) Hospital-based before and after study with qualitative component Eritrea, remote areas of two coastal regions of the Red sea 655,279 people
11 MWH
11 health facilities with MWH for women living at least 10 km distance from facility. MWHs had an ambulance for referal to higher level facilities for complications. During admission, consumables were provided to women. Community support provided through supplies. Equity considerations made for women residing more than 10 km from health facility. Staff at MWH were trained. Part of a strategy implemented by MOH
Chandra-mohan et al. (1994) Hospital cohort (childbirth outcomes over time) Zimbabwe, Rural 208,000 people
Free self-catering temporary accommodations 150 m from labour ward. Women advised to stay at MWH from 36 weeks gestation. Target population was women identified as risk in ANC. MWH offered ANC and health education.
Chandra-mohan et al. (1995) Cohort analytic (two group pre + post) Zimbabwe, Rural 208,000 people
See Chandramohan et al., 1994
Danel et al. (2003) World bank report Honduras, National Population nr
Attached to rural hospitals.
Ecker-mann et al. (2008) Case study with qualitative components Lao People’s Democratic Republic (PDR), Remote-rural 27,539 people
No MWH, 17 to be built
Improve maternal outcomes in remote communities with a high proportion of ethnic minorities and disadvantaged groups economically and in health indices. Women provided with nutrition and baby care training, handicraft training and have opportunity to earn an income while staying at MWH. All given information and opportunities for micro-credit initiatives. MWHs designed for privacy before, during and after birth (for uncomplicated births conducted in MWH in traditional birthing position)
Feresu et al. (2003) World bank report Zimbabwe National Overview of 255 MWH  
Fraser (2008) Case study Peru, Rural and urban Population nr
(390 available nationally)
Reported outcomes of key interventions to address MMR in Peru. MWH near health centres that refer cases to hospitals. MWH are part of a strategy implemented by MOH
Garcia Prado et al. (2012) Cross-sectional survey and qualitative components Nicaragua, Rural Population nr
18 MWH
Women spend 2 weeks before and 1 week after childbirth at MWH, where food and lodging is provided. Most homes extend their services beyond medical visits and education on SHR, offering advice and counselling on diverse issues (domestic violence, selling handmade prouducts, and obtaining identify cards or land titles). Women referred from mobile health teams and TBAs. Situated near health centres. MOH has a strategy to promote MWHs.
Gaym et al. (2012) Hospital based cohort with a qualitative component Ethiopia, Rural Population nr
Faith based organizations pioneered the construction of MWHs in Ethiopia since the late 1980’s, then adopted by NGOs as well as public health facilities. Conditions within each varied, activities included outreach to increase community awareness of MWHs. Women referred by staff at peripheral health facilities, and outreach teams. Women also came based on recommendations from other women who had used facility. Situated within compound of health facility.
Gorry (2011) Case study Cuba, Rural and urban Population nr
327 MWH
15 MWHs were introduced in 1962 and grew to 327. Existing houses are reconditioned to create a home-like environment for monitoring health and wellbeing of woman and fetus. Concept has been further developed to emphasize nutrition and diet, and provision of ambulatory services so women can take meals and classes at MWH, but return home in the evenings. MWHs follow guidelines designed by Ministry of Public Health’s maternal child health program in collaboration with UNICEF, describing criteria for admission, diagnostic and clinical guidelines for identifying risk factors and protocols for treatment in MWHs.
Kelly et al. (2010) Hospital cohort (childbirth outcomes over time) Ethiopia, Rural 800,000 people
40 bed MWH, located within hospital grounds. Original facility built in 1973 in local style with thatched roof, which caught fire in 1999; replaced by corrugated roof. A companion resides at MWH, finds firewood and food, and cooks for her. High-risk women spend last few weeks of pregnancy in MWH.
Knowles et al. (1988) Case study Malawi Population nr
Women referred from other medical facilities and can self-refer. Situated in hospital ground.
Larsen et al. (1978) Hospital cross sectional survey South Africa, Rural nr Nr
Lori et al. (2013a) Qualitative study Liberia, Rural, post conflict 78,446 people
Served women affected by conflict. Women self-refer. Situated near health facilities.
Lori et al. (2013b) Cohort analytic (two group pre + post) Liberia, Rural post conflict >50,000 people
Served women affected by conflict.
Martey et al. (1995)   Ghana, Rural 131,229 people
Millard et al. (1991) Hospital cohort study Zimbabwe, Rural Population nr
Women self-referred themselves to the facility. 2 min walk from hospital. MOH policy exists supporting MWHs.
Mramba et al. (2010) Cross sectional survey, qualitative components Kenya Population nr
50 m from the maternity unit at a District Hospital. It has a capacity of 40 people: 20 pregnant women and 20 healthcare workers. Referrals mostly by health workers. Referrals from health workers.
Poovan et al. (1990) Hospital cross-sectional survey Ethiopia, Rural 300,000 people
Women referred during outreach ANC conducted by nurse midwives and TBAs. Situated close to the hospital.
Ruiz et al. (2013) Qualitative study Guatemala,
Population nr
Focus on attracting indigenous women. Women referred from TBAs and health centre physicians. Women could also self-refer. 3 km from the hospital. Part of a MOH strategy to increase utilisation in this region.
Schooley et al. (2009) Qualitative inquiry (focus groups and in-depth key informant interviews, unstructured, focused observations) Guatemala Population nr
Focus on increasing utilisation of health services by indigenous women. Situated adjacent to a local hospital.
Shrestha et al. (2007) Cross-sectional survey and qualitative component Nepal, Lowland conflict Population nr
Study not linked to existing MWH (27 MWH available)
Working in a context of conflict. MOH supported MWH to increase health facility utilisation.
Spaans et al. (1998) Household-level cross-section Zimbabwe Population nr
In the hospital grounds.
Tumwine et al. (1996) Cohort analytic (two group pre + post) Zimbabwe 100,000 people
Number of MWH nr
Women referred by health centre staff, TBAs and could refer themselves. 100 m from hospital.
van Lonkhuij-zen et al. (2003) Hospital cross-section Zambia, Rural 60,000 people
Women referred during monthly outreach clinics conducted by midwives. Situated next to hospital.
Wessel(1990) Case study Nicaragua, Rural Population nr
Aimed at supporting refugees from the civil war. Self-referral.
Wild et al. (2012) Interrupted time series Timor-Leste Remote-rural >100,000 people
Connected by a walkway to the hospital, and near a health centre. MOH run as part of their maternal health strategy.
Wilson et al. (1997) Qualitative study, with MWH utilisation rates Ghana, Rural 126,000 people
Referrals from private midwives and health posts. Situated in an unused ward in the hospital.
  1. 1 Year of study or report; 2 Catchment population reportedly covered by MWH and number of MWH included in article; 3 Health indices reported as background levels in the article only, pertinent to locality, population of interest and time period where available. Health indices as a result of the MWH intervention not included
  2. Abbreviations: MMR = maternal mortality ratio/100000, PMR = perinatal mortality/1000, SBA = skilled birth attendance, IDR = institutional delivery rate, HB = home births, ANC = antenatal care, PHC = primary health centres, TBA = traditional birth attendants, MOH = ministry of health nr = not reported