TY - JOUR T1 - A Qualitative Exploration of Community Ownership of a Maternity Waiting Home Model in Rural Zambia JF - Global Health: Science and Practice JO - GLOB HEALTH SCI PRACT SP - 344 LP - 357 DO - 10.9745/GHSP-D-20-00136 VL - 8 IS - 3 AU - Constance P. Fontanet AU - Rachel M. Fong AU - Jeanette L. Kaiser AU - Misheck Bwalya AU - Thandiwe Ngoma AU - Taryn Vian AU - Godfrey Biemba AU - Nancy A. Scott Y1 - 2020/09/30 UR - http://www.ghspjournal.org/content/8/3/344.abstract N2 - Key FindingsCommunity members’ perceptions of ownership were related to their ability to use the maternity waiting home (MWH) and feeling a sense of responsibility toward its success.Representing their community’s interests was a crucial component of the role of the governance committee and management unit.Collaboration between the governance committee and the health facility staff was key to allowing the MWH to meet its goal of serving the community.Key ImplicationTo improve the sustainability of community-based maternal and child health programs, program managers should ensure that interventions are accessible to target communities and clear roles are established among stakeholders.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. ER -