On-going Research

Factors Affecting the Success and Failure of Maternity Waiting Homes in Nepal

16 Aug, 2019

Maternity Waiting Homes (MWHs) are structures built at or near a health facility for pregnant women to stay at the end of their pregnancy so they can be transported easily to the health facility for delivery. MWHs were introduced in 1970s in order to create access to institutional delivery services. They were primarily utilized by the high-risk pregnant women who live far away from the health facilities. It can be an intervention aimed at eliminating the phase II delay by bringing women closer to facilities to deliver. It goes by many different names, but in general are accommodations at or nearby a health facility where pregnant women and accompanying family member can stay in the final weeks leading up to delivery.

Nepal is an illustrative example of how MWHs can succeed and fail, and understanding the reasons for success or failure is imperative to informing the design and implementation of future MWHs in Nepal and elsewhere. The first 27 MWHs in Nepal were constructed by the Ministry of Health and Population (MoHP) with the support from UNFPA, none of which were found to be functional in a 2007 MWH feasibility study. Today, at least few MWHs are still operating in Nepal. In the FY 2075/76, the provincial government of Karnali (Province 6) of Nepal planned and implemented a program to operate maternity hostels (waiting homes) in all primary and tertiary hospitals with in the province by allocating some budget to offer a residential facility for the pregnant women in order to provide quality maternity care. There are few initiatives in other parts of the country. Similar services are provided by Mission Hospital (Palpa), Achham district hospital and Meringden Rural Municipality (Taplejung). Learning from the successes and failures of both operational and non-operational MWHs, as well as the experiences of users and non-users, is crucial to document the factors for success and failure for future interventions.

This study will explore the factors for successes and failures of MWHs in Nepal by conducting semi-structured interviews with administrative/programmatic leaders and staff, as well as the service users and non-users. We will seek to understand the reasons for successful and failed MWHs in order to inform future MWH interventions in the new federal structure of Nepal.

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