Utilisation of maternity waiting homes and its associated factors in Ethiopia: Systematic reviews and meta-analysis

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Background Maternity waiting homes are residential facilities near or in a qualified medical facility where women classified as "high risk" can wait for their delivery before being transferred to a nearby medical facility. Ethiopia has been implementing maternity waiting homes to reduce maternal and prenatal mortality, though utilisation varies significantly between facilities. Thus, this systematic review and meta-analysis was aimed to estimate the pooled prevalence and determinants of maternity-waiting home utilisation in Ethiopia. Methods In this study, variables were searched from different electronic database systems, including PubMed/Medline, CINHAL, Scopus, Web of sciences, google scholar and Grey literature. Data were extracted guided by a standardised data collection measurement tool. The data were analysed using STATA 16 statistical software, and I 2 tests assessed heterogeneity between the studies. A random-effect model was used to forecast the pooled utilisation of maternity waiting homes. Results Twelve observational studies were included in this review. The pooled prevalence of utilisation of maternity waiting homes in Ethiopia was 44.91%. Attended antenatal care visits (OR = 2.87, 95%CI, 1.75–4.69), history of complication (OR = 2.05, 95%CI, 1.32–3.16), travel time to obstetric care facility >30 min (OR = 2.75, 95%CI, 1.87–4.06), poverty (OR = 4.04, 95%CI, 1.46–11.19), experience of maternity waiting home use (OR = 2.90, 95%CI, 1.14–7.38) and childbirth in the health facility (OR = 11.86, 95%CI, 4.02–35.01) were significantly associated with utilisation of maternity waiting home. Conclusions This systematic review and meta-analysis revealed that the utilisation of maternity-waiting homes was low in Ethiopia. Thus, concerned stakeholders must design and implement effective interventions to increase maternity-waiting home utilisation and tackle the determinants that deter its utilisation.