Planning for Maternity Waiting Home Bed Capacity: Lessons from Rural Zambia

[i] Abbreviations: RHC = Rural health center; HFCA = Health Facility Catchment Area.

^a See explanation of RHC location categories in Methods section. Rural = 20–49 km; Rural-remote = 50+ km. The furthest rural health center is 68 km from the nearest referral hospital. GPS coordinates at RHCs and referral hospitals were collected by project staff. Distance data were calculated using ArcGIS® Online.

^b Official HFCA size data are from the 2012 List of Health Facilities in Zambia.

^c HFCA population size categories were assigned by the research team based on natural breaks in the official HFCA population size figures of each rural health center. Small = <9000 population; medium = 9000–11000 population = large >11000 population.

^d Projected by multiplying official HFCA population size in 2012 by the Crude Birth Rate (rural) in the 2013/2014 Demographic and Health Survey (40.3 births per 1000 population).

^e Delivery volume data are from the Zambian health management information system (HMIS) for 2014, provided by the Saving Mothers, Giving Life project.

^fProjected occupancy of MWH = projected bed days/available bed days per month. Projected bed days = projected users per month (births in HFCA or delivery volume) * average length of stay (10 days). Available bed days per month = (Number of beds [10] * days in a year [365])/month (12). Average length of stay was based on formative research conducted in these districts.²⁷ Assumes 100% of either HFCA births or RHC deliveries will stay at the MWH.

^gRural health center delivery records extracted by research team for August 2017 – July 2018.

^hActual occupancy of MWH = bed days/available bed days, averaged over 12 months. Based on MWH register data, users’ arrival and departure dates, and reason for stay (awaiting delivery).