Waiting Houses in Mozambique Aim to Decrease Maternal Mortality

Waiting houses, or Casas de Espera, as they are referred to in Mozambique, allow at-risk pregnant women to reside in a home near the local hospital in order to provide immediate care when labor begins. As many of Mozambique's citizens live in rural areas, far from a reliable hospital, these waiting houses are crucial to prevent pregnancy related complications and maternal death from occurring. The Mozambique government has recently decided to revamp its waiting house programme in order to combat maternal mortality and progress toward achieving MDG5.

At the African First Ladies Health Summit last week Maria de Luz Guebuza, the First Lady of Mozambique, explained how 75% of Mozambique's 128 districts now have waiting houses for mothers-to-be. By providing such accommodations, pregnant women are able to travel before their labor begins and remain in the vicinity of well trained professional health care workers, should a complication arise. Women in the community at risk for complicated deliveries, such as pre-eclampsia, history of cesarean section or severe bleeding, malpresentation, or cases of multiple births, are often advised to travel to a casas de espera anywhere from 2 to 4 weeks before their pregnancy. Once there, the women are often able to learn from midwifes on pregnancy-related topics such as development of the fetus, labour and delivery, breast-feeding, immunization and family planning. In some cases the women use their spare time to make crafts and dresses, in order to sell their products to the local community and generate funds for maintenance. Since most of these houses are free of charge, any extra revenue is especially helpful in maintaining the facilities.

Mozambique is not alone in providing such waiting houses. Many other countries throughout Africa and Asia have instituted similar programmes and are moving toward achieving MDG5. In 1987, a study was conducted in Zimbabwe that found that women who stayed in these antenatal accommodations experienced better pregnancy outcomes than those women who entered the hospital directly from the community. Since then, improvements have been made and the effectiveness of such a program is remarkable. In addition to maternal mortality decreasing, infant survival rates are also being positively affected.

It is crucial that governments provide funding for such initiatives and that South-South cooperation continues to be emphasized at international conferences, such as the African First Ladies Health Summit. By sharing the effectiveness of such a program with other regional leaders and policy makers, it is PPD's hope that maternal mortality can be significantly reduced in the next few years.

You can read about other country case studies at http://who.int/reproductive-health/publications/MSM_96_21/MSM_96_21.chap4.en.html