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APHA Scientific Session and Event Listing

Sujata I. Naik, MPH¹, Sara Groves, DrPH, MSN¹, Judy Lewis, MPhil², and Yvette Wild, BS². (1) Haitian Health Foundation, 10 Rue Rochasse, Jeremie, Haiti, 001-509-284-5216, suju@med.umich.edu, (2) Department of Community Medicine, University of Connecticut, 263 Farmington Avenue, Farmington, CT 06030-1925

Haitian women and newborns have the highest mortality rates in the western hemisphere (680/100,000 MMR and 36/1,000 neonatal MR). High-risk pregnancies are detected during antenatal consultations, but many women die in the community or come to the hospital too late. Safe motherhood should be a fundamental human right. This presentation describes the first Maternity Waiting Home (MWH) in Haiti which makes hospital care accessible to high risk pregnant women from isolated areas.

The MWH began in August 2002 with 30 beds. Initial utilization was low. Research demonstrated lack of mother's awareness of risk, low knowledge of prenatal care, and lack of child care were significantly associated with low utilization. Social and financial costs associated with hospital delivery limited access. Outreach programs addressed these concerns and increased utilization.

Demographic, birth history, admission criteria, laboratory results, and pregnancy outcome data has been collected on all 230 women using MWH to date. Principal reasons for admission were severe anemia (29%), hypertension (13%), previous cesarean (6%), and HIV (4.8%). Mean length of stay was two weeks (range 1 week-3 months), average birth weight was 3.1 kg (range 1.7-4.5). There were no maternal deaths, 25 caesareans, and 24 stillbirths. Current research is examining the effectiveness of outreach programs and associated MWH outcomes using a control group of at risk pregnant women who did not use MWH.

Community education about the MWH and the development of a functional referral system have increased access to care and begun to reduce maternal and newborn morbidity and mortality rates.

Learning Objectives:

• To articulate the need for Maternal Waiting Homes to ensure women’s rights to safe pregnancy and delivery.
• To identify barriers and facilitators to utilization of Maternal Waiting Homes.
• To evaluate the impact of Maternal Waiting Homes on maternal and neonatal morbidity and mortality.

Keywords: Safe Mother Program, Maternal and Child Health

Presenting author's disclosure statement:

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