Determinants of maternal near-miss among women admitted to maternity wards of public hospitals in hadiya zone, southern Ethiopia

Abstract

BACKGROUND: Reducing maternal mortality ratio below 70 per 100,000 live births for all countries by the year 2030 is one of the targets of the UN sustainable development goals. Hence, identifying the determinants of maternal near-miss would contribute to accelerating the achievement of this target. However, studies on these issues are limited in Ethiopia in general and in Hadiya Zone in particular. OBJECTIVE: To identify determinant factors of maternal near-miss among women admitted to maternity wards of public hospitals in Hadiya Zone, South Ethiopia. METHODS: Facility based unmatched case-control study was conducted from February 17 to May 9, 2019. A total of 279 women (70 cases and 209 controls) were included in the study. Cases were mothers with near-miss and controls were mothers who didn’t experience near-miss. The data were analyzed by using SPSS version 24 and statistical significance was assessed using multivariable binary logistic regression model by determining odds ratios and 95% CIs. RESULTS: The most common near-miss event in this study was severe pre-eclampsia (41.4%) followed by sepsis (31.4%), severe PPH (25.7%), eclampsia (8.6%) and uterine rupture (1.4%). Being in rural residence (AOR = 3.16; 95%CI: 1.62, 6.16), no birth preparedness (AOR = 3.50; 95%CI: 1.66, 7.41), previous 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. CONCLUSION: Severe pre-eclampsia is the leading maternal near-miss event in Hadiya zone. Rural residence; reproductive and obstetric factors such as no birth preparedness, previous cesarean section, and poor knowledge of pregnancy danger signs; and previous history of hypertension were significant determinant factors of maternal near-miss. Thus strengthened public health and clinical interventions on these arenas need to give priority for rural women and women with preexisting hypertension.