Ethiopia is one of the sub-Saharan Africa countries with the highest maternal mortality. Maternal near-misses are more common than deaths and statistically stronger for a comprehensive analysis of the determinants. The study aimed to identify the factors associated with maternal near-miss in selected public hospitals of Addis Ababa, Ethiopia.
We conducted a nested case-control study in five selected public hospitals of Addis Ababa, Ethiopia from May 1, 2015 to April 30, 2016. Participants were interviewed by well-trained data collectors using pre-tested questionnaire. Medical records were also reviewed to gather relevant information. World Health Organization criteria were used to identify maternal near-miss cases. A total of three controls matched for age and study area was selected for each maternal near-miss case. Bivariate and multivariable conditional logistic regressions were performed using Stata version 13.0.
A total of 216 maternal near-miss cases and 648 controls were included in the study. The main factors associated with maternal near-miss were: history of chronic hypertension (AOR = 10.80,95% CI; 5.16–22.60), rural residency (AOR = 10.60,95% CI;4.59–24.46), history of stillbirth (AOR = 6.03,95% CI;2.09–17.41), no antenatal care attendance (AOR = 5.58,95% CI;1.94–16.07) and history of anemia (AOR = 5.26,95% CI;2.89–9.57).
There is a need for appropriate interventions in order to improve the identified factors. The factors can be modified through a better access to medical and maternity care, scaling up of antenatal care in rural areas, improve in infrastructure to fulfill referral chain from primary level to secondary and tertiary health care levels, and health education to pregnant women.
United Nations. Transforming our world: the 2030 agenda for sustainable development. New York: United Nations; 2015.
WHO, UNICEF, UNFPA, World Bank Group, and United Nations Population Division. Trends in Maternal Mortality: 1990 to 2015 Estimates by WHO, UNICEF, UNFPA, The World Bank and the United Nations Population Division. Geneva: World Health Organization; 2015.
Central Statistical Agency (CSA) [Ethiopia], ICFI. Ethiopia Demographic and Health Survey 2016: Key Indicators Report. Addis Ababa and Rockville: Central Statistical Agency and ICF International; 2016.
Ethiopia Central Statistical Agency, ICFI. 2011 Ethiopia demographic and health survey: key findings. Addis Ababa and Calverton: Central statistical agency and ICF international; 2012.
The World Health Organization (WHO). The H4+ Partnership joint support to improve women’s and children’s health progress report 2014. Geneva: World Health Organization; 2015.
Elias N, Accorsi S. The last lap towards millennium development goals:the performance of the health sector in EFY 2005. FDRE MOH Quarterly health bulletin. 2014;6(1):14–5.
The World Health Organization (WHO). Beyond the numbers :reviewing maternal deaths and complications to make pregnancy safer. Geneva: World Health Organization; 2004.
The World Health Organization (WHO). Evaluating the quality of care for severe pregnancy complications. The WHO near-miss approach for maternal health. Geneva: World Health Organization; 2011.
Amaral E, Souza JP, Surita F, Luz AG, Sousa MH, Cecatti JG, Campbell O. A population-based surveillance study on severe acute maternal morbidity (near-miss) and adverse perinatal outcomes in Campinas, Brazil: The Vigimoma Project. BMC Preg Childbirth. 2011;11(1):9. CrossRef
Berhane G, Gessessew A, Roosmalen JV. Obstetric near miss and maternal death:the case of Ayder teaching hospital,Mekelle,Ethiopia. Ethiopian Journal of Reproductive Health. 2012;6(1):56–63.
Lincetto O, Mothebesoane-Anoh S, Gomez P, Munjanja S. Opportunities for Africa's newborns: Practical data, policy and programmatic support for newborn care in Africa. Geneva: World Health Organization; 2006. p. 51-62.
New S, Wirth M. Anaemia, pregnancy, and maternal mortality: the problem with globally standardised haemoglobin cutoffs. BJOG Int J Obstet Gynaecol. 2015;122:166–9. CrossRef
- Distant and proximate factors associated with maternal near-miss: a nested case-control study in selected public hospitals of Addis Ababa, Ethiopia
Ewnetu Firdawek Liyew
Alemayehu Worku Yalew
Mesganaw Fantahun Afework
- BioMed Central
Neu im Fachgebiet Gynäkologie und Geburtshilfe
Meistgelesene Bücher aus dem Fachgebiet
Mail Icon II