July 04, 2024

Giving birth in remote areas can be challenging. Maternity waiting homes can be part of the solution.

Imagine having to give birth in Ethiopia’s remote and fragile Afar region. In this hot, low-land and desert like area, most people are living as pastoralists, trying to make a living as livestock farmers and seasonally migrating with their livestock in search of grazing and water areas. The recent conflict in the northern part of the country has caused further challenges for the people in the Afar region, not least for the expecting mothers and their newborns.  

The rate of institutional deliveries is notably low in the Afar region. The health facilities are often located far away from where the families stay and transportation to the facilities is often not accessible. There are not enough ambulances and many walk or are carried for long distances to seek the care they need.  

Most maternal deaths happen in poor and fragile settings like Afar, but the majority can be prevented with access to quality care. To help ensure that more women in the Afar region get the necessary care, Maternity Foundation and UNFPA have built nine maternity waiting homes in the area.  

These maternity waiting homes are modeled after pastoralists’ accommodations and are located within health facilities’ compound. They serve as temporary residences for pregnant women who live far from health services. By staying here before the start of labour, they receive continuous assistance from midwives during and after childbirth, thereby reducing delays in seeking healthcare and reaching the facility. 

“We have seen an increase in the number of the pastoralist women coming to the health facility to give birth thanks to the new maternity waiting homes. Here, they can get the assistance they need at the right time to deliver their babies safely”, says Faatuma Burahabba, Head of Afambo woreda Health Office, in the Afar region.  

In one of the maternity waiting homes, we meet an expecting mother and ask her, what she thinks of the place: 

“I have given birth at home before but now, I have heard about this new maternity waiting home where you can get good support, and I wanted to come here to get assistance during labour. I feel comfortable here, the maternity waiting home looks like my own home”.  

Studies in Ethiopia show that pregnant women who utilise maternity waiting homes are 80–91 percent less likely to die than their non-user counterparts. In addition, there is a 73–83 percent lower occurrence of stillbirth compared to non-maternity waiting home users. 

Besides offering care around the time of birth, the maternity waiting homes also offer care in the postnatal period for both the mother and their newborns, providing them with a better start in life.  There are also examples of staff at the health facility who cultivate gardens with vegetables and crops to provide the mothers with a healthier, nutrient-rich diet. The vegetables and crops are also sold to buy items for the maternity waiting rooms, ensuring continued use and financial sustainability. 

At the same time, Maternity Foundation and UNICEF are working to improve the skills and knowledge among the midwives working at the healthcare facilities through mentorship programmes and the digital tool, the Safe Delivery App. The app provides guidance on how to handle birth and obstetric complications. It is free and once downloaded, it also works offline – a valuable feature in areas like the Afar region with limited internet access.  

“Many factors come in play when trying to reduce maternal mortality in remote and fragile contexts like the Afar region in Ethiopia. Building maternity waiting homes to ensure timely care for the expecting mothers is part of the solution, and when combined with building skills and knowledge among the practicing midwives, we can further help improve both access to and quality of maternal healthcare”, says Hiwot  Wubshet, Country Director for Maternity Foundation in Ethiopia. 

Photo: Maternity Foundation/Mulugeta Wolde