Comparison of quality, birth outcomes, and service utilization between health facilities with and without maternity waiting homes in Liberia

OBJECTIVE: 1) To assess the quality of health facilities associated with functional Maternity Waiting Homes and health facilities without functional maternity waiting homes in Liberia. 2) To examine birth outcomes and care utilization amongst health facilities with and without functional maternity waiting homes in Liberia. DESIGN: Secondary analysis design using data from a facility capacity checklist and Liberia's Health Management Information System. SETTING: 71 health facilities associated with functional maternity waiting homes and 14 health facilities without functional maternity waiting homes across 14 counties of Liberia. PARTICIPANTS: No human participants were used in this study. METHODS: Independent t-test, Pearson chi-square test, and logistic regression were performed to assess quality, birth outcomes, and service utilization between health facilities with and without functional maternity waiting homes. FINDINGS: The overall health facility quality was not significantly different between health facilities associated with functional maternity waiting homes and those without. However, health facilities with functional maternity waiting homes had better infection control with the presence of soap and sharps boxes. Health facilities with functional maternity waiting homes were also more likely to have parenteral oxytocic drugs and were better able to perform assisted vaginal deliveries. The presence of functional maternity waiting homes were not significantly associated with health facility quality, birth outcomes, or care utilization. CONCLUSION AND IMPLICATIONS: Health facilities with functional MWHs were better prepared to prevent infection and manage complicated deliveries. This study further highlights specific areas for quality improvement amongst these health facilities, including labor complications management.