Determinants of maternal near-miss among women admitted to public hospitals in the Hadiya zone, central Ethiopia: a case-control study
https://doi.org/10.4081/hls.2024.12474
Accepted: 2 April 2024
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One of the Sustainable Development Goals of the United Nations is to bring the global maternal mortality ratio down to less than 70 per 100,000 live births by 2030. Therefore, pinpointing the factors that influence maternal near-misses would help expedite the accomplishment of this goal. Studies on these topics are, nevertheless, scarce in the Hadiya zone and throughout Ethiopia as a whole. Therefore, the purpose of this study was to determine the factors that contribute to maternal near-misses among women who are admitted to public hospital maternity wards in the Hadiya zone in central Ethiopia. A facility-based, unmatched case-control study was conducted from February 17 to August 16, 2019. The study covered all secondary and tertiary public healthcare facilities in the Hadiya zone, which includes three district hospitals and one referral hospital offering comprehensive emergency obstetric care services. The study included 279 women in total (70 cases and 209 controls). Mothers who had had a near-miss were the cases, and mothers who had not had one were the controls. The Statistical Package for Social Sciences version 24 was used to analyze the data, and the multivariable binary logistic regression model was used to control confounders. The odds ratios (OR) and 95% confidence intervals (CI) were used to determine statistical significance at a p-value of less than 0.05. Living in a rural area [adjusted OR (AOR)=3.16; 95% CI: 1.62, 6.16], no birth preparedness (AOR=3.50; 95% CI: 1.66, 7.41), ever gave birth by cesarean section (AOR=3.68; 95% CI: 1.63, 8.31), previous history of hypertension (AOR=3.69; 95% CI:1.52, 8.96), and poor knowledge of pregnancy danger signs (AOR=3.15; 95% CI: 1.32, 7.52) were all determinants of maternal near-miss. Thus, strengthened public health and clinical interventions in these arenas need to prioritize rural women and women with a previous history of hypertension.
World Health Organization. Health in 2015: from MDGs to SDGs. Available on: https://www.who.int/data/gho/publications/mdgs-sdgs.
Almerie Y, Almerie MQ, Matar HE, et al. Obstetric near-miss and maternal mortality in a maternity university hospital, Damascus, Syria: a retrospective study. BMC Pregnancy Childbirth 2010;10:65. DOI: https://doi.org/10.1186/1471-2393-10-65
Say L, Pattinson RC, Gülmezoglu AM. WHO systematic review of maternal morbidity and mortality: the prevalence of severe acute maternal morbidity (near miss). Reprod Health 2004;1:3. DOI: https://doi.org/10.1186/1742-4755-1-3
Liyew EF, Yalew AW, Afework MF, Essén B. Incidence and causes of maternal near-miss in selected hospitals of Addis Ababa, Ethiopia. PLoS One 2017;12:e0179013. DOI: https://doi.org/10.1371/journal.pone.0179013
Lewis G. Beyond the numbers: reviewing maternal deaths and complications to make pregnancy safer. Br Med Bull 2003;67:27-37. DOI: https://doi.org/10.1093/bmb/ldg009
Kasahun AW, Wako WG. Predictors of maternal near miss among women admitted in Gurage zone hospitals, South Ethiopia, 2017, a case-control study. BMC Pregnancy Childbirth 2018;18:260. DOI: https://doi.org/10.1186/s12884-018-1903-1
World Health Organization. Evaluating the quality of care for severe pregnancy complications. 2011. Available from: https://iris.who.int/bitstream/handle/10665/44692/9789241502221_eng.pdf?sequence=1.
Witteveen T, Bezstarosti H, de Koning I, et al. Validating the WHO maternal near miss tool: comparing high- and low-resource settings. BMC Pregnancy Childbirth 2017;17:194. DOI: https://doi.org/10.1186/s12884-017-1370-0
Tura AK, Stekelenburg J, Scherjon SA, et al. Adaptation of the WHO maternal near miss tool for use in sub–Saharan Africa: an International Delphi study. BMC Pregnancy Childbirth 2017;17:445. DOI: https://doi.org/10.1186/s12884-017-1640-x
Kaye DK, Kakaire O, Osinde MO. Systematic review of the magnitude and case fatality ratio for severe maternal morbidity in sub-Saharan Africa between 1995 and 2010. BMC Pregnancy Childbirth 2011;11:65. DOI: https://doi.org/10.1186/1471-2393-11-65
Gebrehiwot Y, Tewolde BT. Improving maternity care in Ethiopia through facility-based review of maternal deaths and near misses. Int J Gynecol and Obstet 2014;127:S29-34. DOI: https://doi.org/10.1016/j.ijgo.2014.08.003
Lindtjørn B, Mitiku D, Zidda Z, Yaya Y. Reducing maternal deaths in Ethiopia: results of an intervention programme in southwest Ethiopia. PLoS One 2017;12:e0169304. DOI: https://doi.org/10.1371/journal.pone.0169304
Tuncalp O, Hindin MJ, Souza JP, et al. The prevalence of maternal near miss: a systematic review. BJOG 2012;119:653-61. DOI: https://doi.org/10.1111/j.1471-0528.2012.03294.x
Mekango DE, Alemayehu M, Gebregergs GB, et al. Determinants of maternal near miss among women in public hospital maternity wards in northern Ethiopia: a facility-based case-control study. PLoS One 2017;12:e0183886. DOI: https://doi.org/10.1371/journal.pone.0183886
Gedefaw M, Gebrehana H, Gizachew A, Taddess F. Assessment of maternal near miss at Debre Markos referral hospital, northwest Ethiopia: five years experience. Open J Epidemiol 2014;4:199-207. DOI: https://doi.org/10.4236/ojepi.2014.44026
Dile M, Seyum T. Proportion of maternal near misses and associated factors in referral hospitals of Amhara regional state, northwest Ethiopia: institution-based cross-sectional study. Gynecol Obstet 2015;5:308.
Liyew EF, Yalew AW, Afework MF, Essén B. Distant and proximate factors associated with maternal near-miss: a nested case-control study in selected public hospitals of Addis Ababa, Ethiopia. BMC Womens Health 2018;18:28. DOI: https://doi.org/10.1186/s12905-018-0519-y
United Nations. Transforming our world: the 2030 agenda for sustainable development. 2015. Available from: https://sdgs.un.org/2030agenda.
Ethiopian Public Health Institute FMoH. Ethiopia Mini Demographic and Health Survey 2019.
World Bank, Ministry of Health Ethiopia. Ethiopia. A Country status report on health and poverty. 2005.
Assarag B, Dujardin B, Delamou A, et al. Determinants of maternal near-miss in Morocco: too late, too far, too sloppy? PloS One 2015;10:e0116675. DOI: https://doi.org/10.1371/journal.pone.0116675
Bakshi RK, Roy D, Aggarwal P, et al. Demographic determinants of maternal “near-miss” cases in rural Uttarakhand. Natl J Community Med 2014;5:329-32.
Aduloju OP, Aduloju T, Ipinnimo OM. Profile of maternal near miss and determinant factors in a teaching hospital, southwestern Nigeria. Int J Obstet Gynaecol Res 2018;5:598-617. DOI: https://doi.org/10.18203/2320-1770.ijrcog20183752
Soubeiga D, Gauvin L, Hatem MA, Johri M. Birth Preparedness and complication readiness (BPCR) interventions to reduce maternal and neonatal mortality in developing countries: systematic review and meta-analysis. BMC Pregnancy Childbirth 2014;14:129. DOI: https://doi.org/10.1186/1471-2393-14-129
Akrawi VS, Al-Hadithi TS, Al-Tawil NG. Major determinants of maternal near miss and mortality at the maternity teaching hospital, Erbil city, Iraq. Oman Med J 2017;32:386-95. DOI: https://doi.org/10.5001/omj.2017.74
Adeoye IA, Onayade AA, Fatusi AO. Incidence, determinants and perinatal outcomes of near miss maternal morbidity in Ile-Ife Nigeria: a prospective case-control study. BMC Pregnancy Childbirth 2013;13:93. DOI: https://doi.org/10.1186/1471-2393-13-93
De Moraes APP, Barreto SM, Passos VMA, et al. Severe maternal morbidity: a case-control study in Maranhao, Brazil. Reprod Health 2013;10:11. DOI: https://doi.org/10.1186/1742-4755-10-11
Hailu M, Gebremariam A, Alemsged F. Knowledge about obstetric danger signs among pregnant women in AlettaWondo district, Sidama zone, Southern Ethiopia. Ethiop J Health Sci 2010;20:25-32. DOI: https://doi.org/10.4314/ejhs.v20i1.69428
World Health Organization. Standards for maternal and neonatal care. https://iris.who.int/bitstream/handle/10665/69735/a91272.pdf?sequence=1.
Federal Democratic Republic of Ethiopia - Ministry of Health. National reproductive strategy 2006-2015. 2006. Available from: https://www.exemplars.health/-/media/files/n-mmr/ethiopia-national-reproductive-health-strategy-2006-2015.pdf
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