Title
A Qualitative Exploration of Community Ownership of a Maternity Waiting Home Model in Rural Zambia
Document Type
Article
Publication Date
6-30-2020
Abstract
Context
Ownership is an important construct of sustainability for community-based health programming, though it is often not clearly defined or measured. We implemented and evaluated a community-driven maternity waiting home (MWH) model in rural Zambia. We engaged stakeholders at all levels and provided intensive mentorship to an MWH governance committee comprised of community-selected members. We then examined how different stakeholders perceive community ownership of the MWH.
Methods
We conducted 42 focus group discussions with community stakeholders (pregnant women, fathers, elders, and community health volunteers) and 161 in-depth interviews with MWH stakeholders (health facility staff, district health officials, and MWH governance committee and management unit members) at multiple time-points over 24 months. We conducted a content analysis and triangulated findings to understand community ownership of the MWH and observe changes in perceptions of ownership over time.
Results
Community members’ perceptions of ownership were related to their ability to use the MWH and a responsibility toward its success. Community and MWH stakeholders described increasingly more specific responsibilities over time. Governance committee and management unit members perceived their ability to represent the community as a crucial component of their role. Multiple respondent types saw collaboration between the governance committee and the health facility staff as key to allowing the MWH to meet its goal of serving the community.
Conclusion
The perceptions of community ownership evolved as the intervention became more established. Use of the MWH, and clear understanding of roles and responsibilities in management of the MWH, seemed to foster feelings of community ownership. To improve the sustainability of community-based maternal and child health programs, interventions should be accessible to target communities and clear roles should be established among stakeholders.
DOI
https://doi.org/10.9745/GHSP-D-20-00136
ORCID
https://orcid.org/0000-0002-6968-7002
Recommended Citation
Fontanet CP, Fong R, Kaiser JL, Bwalya M, Ngoma T, Vian T, Biemba G, Scott NA. (2020). A qualitative exploration of community ownership of a Maternity Waiting Home model in rural Zambia. Global Health: Science and Practice. 8, 3. https://doi.org/10.9745/GHSP-D-20-00136
Included in
African Languages and Societies Commons, Community Health and Preventive Medicine Commons, International Public Health Commons, Maternal and Child Health Commons, Women's Health Commons
