Proportion of maternal near misses and associated factors in the referral hospitals of Amhara National Regional State, north-west Ethiopia: institution-based cross-sectional study

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A maternal near miss (MNM) is one of the quality indicators of obstetric care, beside maternal deaths. According to the United Nations Fund for Population Activity report (UNFPA 2013), for each maternal death in the world, 20 others suffer due to MNM.


The study aimed to assess the prevalence of MNM and associated factors in Amhara National Regional State referral hospitals (ANRSRH), north-west Ethiopia.


An institution-based cross-sectional study was conducted from 1st March 2013 to 30th August 2013. During the study, 806 mothers who visited the maternal health care services at three ANRSRH were systematically selected. The data were collected through face-to-face interviews and direct concealed observations using pre-tested and structured questionnaires. We used Epi Info 3.5.3 and SPSS for Windows version 20 software for data entry and computing descriptive and analytical statistics respectively. To control for confounding factors, multiple logistic regression models were employed.


The study revealed that the overall proportion of maternal near misses was 23.3 % (95% CI 20%, 26%). No formal education (AOR = 2.00, 95% CI 1.09,3.69), ≥ seven days of hospital stay (AOR = 2.49, 95% CI 1.46,4.25), lack of antenatal care (AOR = 2.51, 95% CI 1.50,4.20), presence of administrative-related factors (AOR = 3.85, 95% CI 2.11, 7.03), personal factors (AOR = 4.02, 95% CI 2.34, 6.90), community-related factors (AOR = 3.28, 95% CI 1.67, 6.46) and medical personnel-related factors (AOR = 7. 02 95% CI: 3.89,12.65) were significantly associated with MNM.

Conclusion and recommendations:

This study indicates that the prevalence of MNM is high. Reduction in MNM might be best achieved through strengthening high-quality maternal health care services, designing a health programme which attracts women with little or no education, and investing in health promotion, education and advocacy.

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