A priority not guided by policy? A scooping review of policy and strategic framework on Maternal Waiting Homes

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Abstract Introduction Maternal Waiting Homes (MWHs) are lodgings located near health facilities where women await their delivery date and be transferred to a health facility shortly before delivery or earlier should complications arise. They are a critical strategy to improve maternal health outcomes, as they been identified as a tool for reducing maternal and perinatal mortality, especially in low-resourced countries. However, they are limited countries with deliberate policies to promote their implementation. This study aimed to review the policy and strategic framework of modern maternal waiting homes in Africa and Zambia. Methods We searched published, unpublished, and grey literature from the following sources: Google Scholar, CINAHL, PubMed, Scopus, Medline, and ResearchGate. Initial search between the 25 th and 27 th March 2024 and the final search was re-run on December 18, 2024. We used relevant synonyms and keywords (such as policy on MWHs, strategies on MWHs, National Development Plans, strategic plans, Health policies, and initiatives on MWHs in developing countries or middle- and low-income countries in the English language. The study further reviewed policies, strategies, development plans, and health strategic plans that facilitated the promotion of maternal health in Zambia. Results Database search yielded a total of ninety-four (94) items. Eighteen (18) additional items were located through hand-searching reference at the Zambia National Archives Centre. Ten (10) articles described MWH policies, strategies, and implementation guidelines from the seven (7) countries. From the Zambia National Archives Centre, nine (9) documents comprised policies, national development plans and strategic plans obtained through the national archives centre. Only one country (Timor-Leste) had a deliberate policy on maternal waiting homes. Zambia does not have a policy or strategy in place that promotes maternal waiting homes. Conclusion Like in many other African countries, In Zambia, no strategic policy has been implemented to promote maternal waiting homes. While MWHs are acknowledged in various strategic health plans and some policies, they are not consistently prioritised or adequately funded. countries, including Zambia must have MWHs policy that should employ deliberate strategies to reduce maternal and newborn morbidities and mortalities.

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