DETERMINANTS OF MATERNAL NEAR MISS IN SELECTED HOSPITALS IN HARARI REGION, EASTERN ETHIOPIA.

Abstract

Background: Maternal deaths have been described as the tip of the iceberg and maternal morbidity as the base. Globally out of 136 million women who give birth each year, around 1.4 million women experience near-miss events. For every woman who dies of pregnancy-related causes, 20 or 30 others experience acute or chronic morbidity. However, these were described as the neglected agenda in maternal health. Objective: Investigate determinants of Maternal Near Miss in selected Hospitals in Harari Region. Methods: Hospital based case-control study was conducted. The data records of 306 mothers102 cases and 204 controls who visited the hospitals from January1, 2016- December 31, 2016 for gynecological and obstetric care during their pregnancy or within 42 days of termination of pregnancy were reviewed. A systematic random sampling technique was used to recruit samples. Data extraction tool developed from WHO standard Maternal Near Miss tool was used. The data collected were entered to Epidata Version 3.1 and analyzed using SPSS version 23. Logistic regression was used to compute statistical analysis. AOR, 95% CI and P-values were used to declare the association of variables. Result: The study finding showed that ANC Visit, Bad obstetric history and Referral status have statistically significant association with Maternal Near Miss. All three variables showed positive association with (AOR of 4.13; 95% CI 2.19-7.78), (AOR 4.45; 95% CI 2.38-8.32) and (AOR 2.31; 95% CI 1.24-4.32) for ANC Visit, Bad obstetric history and Referral status respectively. Conclusions: ANC visit, bad obstetric history and referral status are identified as the main determinants that lead to Maternal Near Miss. Recommendations: I would like to recommend Harari Regional Health Bureau and East Hararghe Zone Health Office to strengthen the maternal health care services, improve ANC service and referral linkage at all health facilities.