In Zambia, many women live miles from the closest health facility. They have few, if any, affordable and safe transportation options, making it difficult to receive the care they need during pregnancy, childbirth, and postpartum.

How do we overcome the distance challenge?

To increase access to health facilities, Zambian women often stay at mothers’ shelters. These are residences near health facilities where pregnant women can stay until they go into labor and immediately after childbirth. Unfortunately, these shelters are often in poor condition, provide minimal services, and are not financially sustainable.

What does it take to help a woman from a rural area reach the care she needs?

Through the Mothers’ Shelter Alliance, run-down structures have been transformed into community-owned enterprises offering quality services to pregnant women and new mothers. The Alliance has built or renovated 24 shelters with support from local communities, providing a safe place to stay. While women await childbirth, they also engage in income-generating activities to help sustain the shelters’ operations.

To date, more than 2,000 women have stayed in the shelters. Local communities have also helped establish over 20 micro-businesses that generate enough revenue to cover half of the shelters’ operating costs.

Less than 60 percent of all women in rural Zambia deliver their babies in clinics or hospitals. Dr. Mary-Ann Etiebet discusses the Mothers’ Shelter Alliance, an initiative formed to examine and improve maternity waiting homes.


The community in Nyimba has embraced the mothers’ shelter as a necessity in their community. It is unprecedented. I would not think that both men and women would be able to embrace the idea, but… the response has been overwhelming.

— Dr. Isabelle Malecki, District Director of Health, Nyimba District