Maternal waiting homes (MWHs) are structures built near the healthcare facility, which aim to reduce the distance to accessing maternal health services and bring pregnant women closer to the health facility, near the time of delivery. This reduces the risk of pregnancy complications which can cause maternal and neonatal deaths, or low birth weight. Tsholotsho district adopted the use of Maternal waiting homes as there was an increase in pregnancy-related complications and incidents of maternal death. The study aimed to evaluate the effectiveness of maternity waiting homes in reducing pregnancy-related complications in Ward 5, Tsholotsho District. A 1:1 case-control study was used for the study, which recruited 248 women who attended Sipepa clinic. Data was collected using structured questionnaires and analysis for frequencies, means, proportions and odds ratios at 95% CI was done using SPSS version 29. The study established that Maternal waiting home use was a significant factor for reducing pregnancy complications (AOR���=���0.16, 95% CI 0.09-0.28). Number of antenatal care visits less than 4 was found to be the significant independent risk factor for pregnancy complications (AOR���=���2.9, 95% CI 1.3-6.2). The odds of adequate knowledge of the benefits of maternal waiting homes was 6.9 times higher among women who used MWHs than those who did not (OR���=���6.9, 95% CI: 3.9-12.2). The study provides evidence that MWHs can significantly reduce pregnancy-related complications and improve maternal health outcomes in Sipepa, Tsholotsho. However, barriers to non-use of MWHs, such as lack of privacy, no food variety, and no cooking utensils, must be addressed to maximize the effectiveness of this intervention. There is a need for policymakers and healthcare providers to prioritize the implementation and expansion of MWHs in rural areas of Zimbabwe, where they can have the greatest impact on reducing maternal mortality and morbidity.
