Barriers or bridges? Experiences of pregnant women and the use of waiting mothers’ shelters in rural Zimbabwe

This study explored the experiences of pregnant women in Mawadza rural community, Mutasa District, Zimbabwe, regarding the use and non-use of a waiting mothers' shelter during pregnancy, childbirth, and the post-partum period. Guided by the Second Delay in Thaddeus and Maine's Three Delays Model, it examines how spatial, infrastructural, and socio-economic barriers influenced women's ability to reach maternal health facilities in time. The Second Delay highlights obstacles between deciding to seek care and arriving at a facility, including transport availability, distance, affordability, and social responsibilities that constrain mobility. Qualitative in-depth interviews were conducted with fifteen women who had used the waiting mothers' shelter at Bonda Mission Hospital since 2015 and thirteen key informants. Findings showed that while the shelter offered skilled birth attendance, antenatal education, and postnatal monitoring, utilisation remains low and inconsistent. Barriers included indirect costs, household labour demands, and stigma, particularly for HIV-positive women. Enabling factors include peer support, trust in biomedical care, and engagement of religious institutions. The study concludes that shelter use was influenced by structural, cultural, and economic factors, including gender power dynamics, and offers insights into policies aligned with Zimbabwe's National Development Strategy 1 (NDS1), the Maputo Protocol on Health and Reproductive Rights, and SDGs 3 and 5 to improve maternal health access.