Malawi Ministry of Health


The second intervention implemented by the Initiative is the construction of maternity waiting homes. This is a strategy that aims at reducing the distance of pregnant mothers as they are required to walk from their homes to the health facility for care and delivery. In most rural and hard to reach areas, women deliver at home because they are unable to travel the long distance for delivery at a primary or secondary health facility resulting in delivery complications.   

Some mothers live 40 kilometers or more from the nearest primary health care facility and up to 80 or 100 kilometers from the referral hospital where comprehensive maternity services are available. To reduce the risk of delivering at home or at an unskilled traditional birth attendant residence, where most woman end up with complications or even die, women are encouraged to reside at the health facility towards the end of their pregnancy to be able to access care from skilled birth attendants once they go into labour.

The challenge is that most health facilities do not have enough space to accommodate these mothers who end up sleeping in hospital corridors, tents or even outside in some cases.

Mothers are required to have at least four focused antenatal visits but only 56% of mothers from the rural population are able to meet this requirement. This leaves a considerable number of women with potential complications unchecked, only to suffice with complications or end up as a maternal death if not brought nearer to the primary or secondary health facility.

The maternity waiting homes also serve as a place where health education is given to the mothers and their guardians as nurses and other health care workers are able to come in contact with them on daily basis. Education on family planning,(unmet need 28%)  nutrition, personal hygiene, prevention of Sexually transmitted infections, HIV/AIDS, including prevention of mother to child transmission (PMTCT), prevention of cervical and breast cancer, home management, education of the girl child and lessons on poverty reduction and climate change are also included. Some waiting homes have home craft workers who give the mothers lessons on preparation of nutritious food for the babies, breast feeding and knitting.

These waiting homes are constructed next to health facilities providing a place for women to wait prior to giving birth mainly during the eighth month. Most importantly, it ensures that these women are closely monitored and able to access quality antenatal/post-natal care.

This mitigates the complications that can arise from home deliveries or through the use of traditional birth attendants (TBA). The programme is closely linked to that of the Chiefs who are tasked with encouraging women in their communities to use these public health facilities.