title: Reaching vulnerable women through maternity waiting homes in Malawi.
abstract: OBJECTIVE
  To determine whether two maternity waiting homes (MWHs) supported by the Safe Motherhood Initiative are reaching vulnerable women during the early phase of their implementation.
  
  
  METHODS
  A cross-sectional interview-based study was conducted among women who attended two centers in Malawi with attached MWHs (Area 25 Health Centre, Lilongwe; and Kasungu District Hospital, Kasungu). Between April and June 2015, exit interviews were conducted among MWH users and non-users.
  
  
  RESULTS
  Compared with non-users, MWH users at Area 25 were significantly more likely to report a prior spontaneous abortion (10/46 [21.7%] vs 5/95 [5.3%]; P=0.006) and to be in the lowest wealth quintile (4/87 [4.6%] vs 0/150; P=0.029). Although not significant, a greater percentage of MWH users at Kasungu District Hospital than non-users had a prior stillbirth (6/84 [7.1%] vs 0/77) or spontaneous abortion (3/84 [3.6%] vs 2/77 [2.6%]), and were in the lowest wealth quintile (15/175 [8.6%] vs 5/141 [3.5%]). MWH users at Kasungu lived further from the hospital than did non-MWH users, although the difference was not significant (mean 6.81±9.1 km vs 4.05±7.42 km; P=0.067).
  
  
  CONCLUSIONS
  MWHs offer a promising strategy to reduce maternal mortality in Malawi and other low-income countries.
authors.affiliation: Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.|Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
authors.forename: Kavita
authors.initials: K
authors.lastname: Singh
authors.affiliation: Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.|Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
authors.forename: Ilene
authors.initials: I
authors.lastname: Speizer
authors.affiliation: Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.|Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
authors.forename: Eunsoo Timothy
authors.initials: ET
authors.lastname: Kim
authors.affiliation: Safe Motherhood Initiative, Lilongwe, Malawi.
authors.forename: Clara
authors.initials: C
authors.lastname: Lemani
authors.affiliation: Safe Motherhood Initiative, Lilongwe, Malawi.
authors.forename: Ann
authors.initials: A
authors.lastname: Phoya
mesh_terms: D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006801:Humans; D008295:Malawi; D000068097:Maternal Health / Q000592:standards*; D008428:Maternal Mortality / Q000639:trends*; D011247:Pregnancy; D011295:Prenatal Care / Q000592:standards*; D012112:Residential Facilities / Q000592:standards* / Q000706:statistics & numerical data; D012424:Rural Population; D011795:Surveys and Questionnaires; D035862:Vulnerable Populations; D055815:Young Adult
keywords: Malawi; Maternal health; Maternity waiting homes; Safe Motherhood Initiative; Skilled delivery