MATERNAL AND NEONATAL NEAR MISS AND ASSOCIATED FACTORS AMONG MOTHER WHO GAVE BIRTH AT PUBLIC HOSPITALS IN HARAR, EASTERN ETHIOPIA

Abstract

Background: Maternal and neonatal mortality is a major public health challenge in low-income countries. Yet for every death, there are many more mothers and new-born who suffer a life-threatening complication but survive. Maternal and neonatal near miss has been proposed as a tool for assessment of quality of maternal and neonatal care. Although many countries have made substantial progress on maternal and neonatal health condition, Ethiopia ranks among the top ten countries in terms of neonatal morbidity and mortality, and there is also limited research evidence on magnitude of maternal and neonatal near miss and associated factors in Harar, eastern Ethiopia. Objective: To assess maternal and neonatal near miss and associated factors among women who gave birth at public hospitals in Harar, eastern Ethiopia from August 1- 30,-2023. Methods: Institutional-based cross sectional study was conducted among randomly selected 423 mothers with their neonates in public Hospitals in Harari regional state. Data were collected using structured questionnaire for mothers and standard checklist for new-born. Collected data were entered into Epi-Data version 3.1 and exported into SPSS version 20 for cleaning and analysis. Binary and multiple logistic regressions was applied to compute the adjusted odds ratio (AOR) with 95 % confidence interval to examine association between explanatory and outcome variables. Significant association was declared using AOR at P-value less than or equal to 0.05. Results: Proportion of maternal and neonatal near miss was found to be 9.2% and 22% respectively. The factors associated with maternal near miss were; obstetric hemorrhage [AOR:3.69,95%CI:1.09-2.46], preeclampsia/eclampsia [AOR:3.68;95%CI:1.55-8.74], maternal anemia[AOR:4.98,95%CI:1.245-19.91], maternal sepsis [AOR:3.17;95%CI:1.125-18.57], obstructed labor/Cephalo pelvic disproportion [AOR:3.319;95%CI:1.48-12.519], post-partum hemorrhage [AOR:3.55;95%CI:1.41-8.93] and referral linkage [AOR:2.78, 95%CI:1.29-5.96]. Similarly, obstetric hemorrhage[AOR:5.55,95%CI:1.99-15.47], preeclampsia/eclampsia [AOR:3.05;95%CI:1.432-6.294], premature rapture of membrane [AOR:2.85;95%CI:1.31-6.22], obstructed labor/Cephalo pelvic disproportion [AOR:5.58;95%CI:1.92 16.19], prolonged labor[AOR:4.7,95%CI:1.91-7.12], meconium stained amniotic fluid [AOR: 5.76, 95%CI: 1.71-19.44] NRFHRP [AOR: 3.60, 95%CI: 1.46-8.90], and referral linkage [AOR: 1.512, 95%CI: 1.928-6.464] were associated with neonatal near miss. Conclusion: Maternal and neonatal near miss was found to be a significant public health challenge in eastern Ethiopia. Obstetric complication during current pregnancy, labor-delivery and postpartum period, referral cases and mode of delivery were associated with maternal and neonatal near miss which are preventable. Continue compressive maternal and neonatal care to avoid preventable causes of morbidity and organizing effective referral system in collaborating with various relevant stakeholders.