Intention to Use and Predictors of Use of Maternity Waiting Home among Pregnant Women in Hargeisa City Health Centers, Somaliland

Abstract

Background: Maternity waiting homes (MWHs) can help women receive the necessary obstetric care and referral if needed. However, there is a lack of evidence on whether women have the desire to stay away from their homes and the sociocultural predictors of their decision in Somaliland. Objective: The purpose of this study was to measure predictors of the intention of women to stay in MWHs using the theory of planned behavior in Hargeisa city, Somaliland. Methods: A facility-based cross-sectional study was conducted from in April 2021 in Hargeisa health facilities among 422 randomly selected participants using an interviewer-administered and structured questionnaire. Data were transferred to Epi Data 4.6 and exported to SPSS 20 for further analysis. Descriptive, bivariate, and multivariate binary logistic regression analyses were used. ORs with 95% CIs were used to assess associations, and statistical significance was set at P<0.05. Results: A total of 245 (58%, 95% CI 53.1%–62.8%) pregnant women intended to use an MWH. Multivariate analysis revealed that education (AOR 5.40, 95% CI 3.01–9.69), experience of using an MWH (AOR 3.80, 95% CI 2.32–6.27), multigravidity (AOR 2.2, 95% CI 1.16–4.29), subjective norms (AOR 1.8, 95% CI 1.05–3.11), indirect attitudes toward use of MWHs (AOR 1.9, 95% CI 1.01– 3.92), and indirect subjective norms (AOR 2.0, 95% CI 1.16–3.60) were significantly associated with intention to use an MWH. Conclusion: Using an MWH is not the preference of many women. Personal characteristics, such as education, multigravidity, and perceived social pressure are important predictors of intention to use MWHs. It is important to raise the awareness of women and the community about the benefits of using MWHs in the early management of obstetric complications.