https://orcid.org/0000-0001-5170-7610
Abstract
Background
Pregnancy-related morbidity and mortality continue to have a serious impact on the lives of women all over the world. Women in sub-Saharan Africa accounted for nearly two-thirds of global maternal deaths. The World Health Organization recommends monitoring maternal near-miss provides better information regarding the quality of maternal health care, on which to base action to prevent further death. Accordingly, this study sought to assess the incidence-proportion of maternal near-miss and its risk factors. We have also seen the near-miss-to-mortality ratio and overall maternal mortality index.
Methods
An institution-based prospective cross-sectional study was carried out from February 6, 2017 to March 6, 2017, using the WHO criteria for maternal near-misses at the three randomly selected public hospitals. About 845 participants were enrolled in the study with systematic random sampling techniques. WHO multi-country survey on maternal and neonatal health tool was used. Descriptive statistics and bivariate logistic regression analysis were done. Variables with p-value <0.2 in the bivariate analysis were transferred to multivariable analysis, and during multivariate logistic regression analysis, variables with P-value <0.05 were considered as statistically significant with 95% CI.
Results
There were 5530 live births, 210 maternal near-misses, 17 maternal deaths, and 364 maternal near-miss events. The overall proportion of maternal near-miss is 24.85%. Besides, the ratio of maternal near-misses to maternal mortality was 12.35:1, and the overall mortality index was 7.48%. Parity, residence, a distance of maternal home from the hospital, ANC follow-up, duration of labor, and administration-related problems were found to have statistically significant associations.
Conclusion
The incidence-proportion of maternal near-misses is relatively high when compared against the national target and to other regional studies. Besides, with all its limitations, the outcome indicators and outcome measures in this study seem to suggest optimum care is being given to mothers who suffered from life-threatening complications.
Abbreviations
SPSS, Statistical Solution and System Package; CI, confidence Interval; AOR, adjusted odds ratio; COR, crude odds ratio; LB, live birth; ANC, antenatal care; WHO, World Health Organization; EDHS, Ethiopian Demographic Health Survey; WLTC, women with life-threatening conditions; MNM, maternal near-misses; MD, maternal death; SAMM, severe acute maternal morbidity; HEELP, hemolysis elevated enzyme low platelet; SMOR, severe maternal outcome ratio; MI, mortality index; PPH, postpartum hemorrhage; ICU, intensive care unit; LNMP, last normal menstrual period; MVA, manual vacuum aspiration; IESOC, Integrated Emergency Surgery and Obstetric Care; SNNPR, Southern Nations, Nationalities, and People’s Region.
Data Sharing Statement
The datasets supporting the conclusions of this article are included within the article and its additional files.
Ethical Approval and Consent
This study was conducted in accordance with the declaration of Helsinki. Ethical approval was obtained from Mizan Tepi University ethical review board, the official permission was obtained from the selected hospital. After the objectives of the study were explained and participants were informed that they had full right to withhold information, skip questions, or to withdraw from the study at any time, informed written consent was obtained from them. For participants under the age of sixteen, we obtained written informed consent from their parents or guardian. The consent process for this study was approved by the Mizan Tepi University Ethical Review Board.
Acknowledgment
We would like to address our gratitude to our colleagues for the effort they made to enrich our Research with an important guide and input. We are thankful to Mizan-Tepi university Midwifery department staff for their continuous support and follow-up from developing this proposal to the end of the finding. We are also thankful for our data collectors and study participants. Also, we would like to acknowledge Bench-Maji, Keffa, and Sheka zone Health Bureau staff for their unlimited cooperation of sharing valuable data when needed which lay a base for the finalization of this research finding.
Authors’ Information
Yayehyirad Yemaneh Adinew (MSc in Clinical Midwifery), lecturer in Mizan-Tepi University College of Health Sciences, Department of Midwifery; Firew Tiruneh Tiyare (MSc in Child Health), lecturer in Mizan-Tepi University College of Health Sciences, Department of Midwifery.
Author Contributions
All authors made substantial contributions to conception and design, acquisition of data, or analysis and interpretation of data; took part in drafting the article or revising it critically for important intellectual content; agreed to submit to the current journal; gave final approval of the version to be published; and agree to be accountable for all aspects of the work.
Disclosure
The authors report no conflicts of interest for this work.