International Journal For Multidisciplinary Research

E-ISSN: 2582-2160   •   Impact Factor: 9.24

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Utilization of maternity waiting homes and associated factors among pregnant women in Kirehe district, Rwanda

Author(s) Mr. Mugabo Frank
Country Rwanda
Abstract Maternal mortality remains a significant public health concern despite global and national efforts to improve maternal health outcomes. In Rwanda, although maternal mortality declined from 1,071 to 203 deaths per 100,000 live births between 2000 and 2020, preventable causes related to delays in accessing care persist, particularly in rural areas. Maternity waiting homes (MWHs) have been recommended by the World Health Organization as a strategy to reduce delays in reaching skilled obstetric care. However, their utilization remains limited and not well documented in rural districts such as Kirehe. Understanding the factors influencing the utilization of maternity waiting homes is important for informing maternal health interventions and policies aimed at improving access to skilled obstetric care and reducing preventable maternal deaths in rural communities. This study aimed to assess the level of utilization of maternity waiting homes and identify socio-demographic and obstetric factors associated with their use among pregnant women in Kirehe District, Rwanda. A quantitative approach using a descriptive cross-sectional study design was employed. The study was conducted in selected health facilities in Kirehe District among pregnant women and recently delivered women aged 15–49 years. A sample size of 300 respondents was determined using Yamane’s formula and selected through a multistage sampling technique, including purposive selection of the district, random selection of health facilities, and systematic random sampling of participants. Data were collected using a structured questionnaire, pretested for validity and reliability (Cronbach’s alpha ≥ 0.7). Data were analyzed using SPSS version 26. Descriptive statistics were used to summarize variables, while binary logistic regression analysis (bivariate and multivariate) identified factors associated with maternity waiting home utilization. Variables with p ≤ 0.25 in bivariate analysis were included in the multivariate model. Statistical significance was set at p < 0.05, and adjusted odds ratios (AOR) with 95% confidence intervals were reported. The findings revealed that 62.0% of respondents had heard about maternity waiting homes, while only 46.3% reported utilizing them. The majority of respondents were aged 25–34 years (39.3%), married (75.0%), and residing in rural areas (69.0%). More than half (53.7%) belonged to low-income households, and 56.3% reported difficulty accessing transport services. Multivariate logistic regression analysis showed that household income, partner occupation, access to transport, and awareness of maternity waiting homes were significantly associated with utilization. Women from low-income households were more likely to utilize MWHs compared to those from high-income households (AOR = 2.398, 95% CI: 1.153–4.987, p = 0.019). Women whose partners were farmers were less likely to utilize MWHs (AOR = 0.491, 95% CI: 0.244–0.989, p = 0.046). Similarly, women with easy access to transport were less likely to use MWHs (AOR = 0.437, 95% CI: 0.268–0.714, p = 0.001). Awareness of MWHs was also significantly associated with utilization (AOR = 0.372, 95% CI: 0.228–0.607, p < 0.001). Obstetric factors including gravidity (p = 0.934), parity (p = 0.589), antenatal care attendance (p = 0.104), number of ANC visits (p = 0.372), and birth planning (p = 0.197) were not statistically significant. The study concludes that utilization of maternity waiting homes in Kirehe District remains low and is mainly influenced by socio-economic and accessibility-related factors rather than obstetric characteristics. Strengthening community awareness, improving accessibility to maternity waiting homes, and addressing transport-related barriers are essential strategies for enhancing utilization and improving maternal health outcomes in rural Rwanda.
Keywords Maternal mortality; Maternity Waiting Homes; Utilization; Maternal health; Socio-demographic factors; Access to healthcare; Kirehe District, Rwanda.
Published In Volume 8, Issue 4, July-August 2026
Published On 2026-07-05
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E-ISSN 2582-2160
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CrossRef DOI prefix of IJFMR is 10.36948/ijfmr

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