Decreasing and Maintaining Low Maternal Mortality Rate and Near Miss in Kocaeli District

Purpose: Every dying woman goes through a phase where her life could have been saved with effective and timely intervention.In this study, we aimed to report how the maternal mortality ratio (MMR) and maternal near-miss ratio (MNMR) were impressively reduced in Kocaeli between 2009 and 2014.Methods: Patient files who delivered in Kocaeli between 2009-2017 were retrospectively reviewed.These data were obtained from Kocaeli Health Directorate, maternal deaths were determined by the Maternal Mortality Research Commission between 2009-2017, and the data were sorted according to three delay models.Results: There were 192,815 deliveries assessed, 312 near miss cases and 32 death reported in 2009-2015 at Kocaeli.MNMR was 3.75 in 2010, it decreased significantly to 0.61 in 2015 (p=0.02).The MMR had decreased significantly from 32.9 in 2009 to 3.3 per 100,000 live births in 2014 in Kocaeli (p=0.007)whereas it was 15.2 in 2014 in Turkey. Conclusion:A citywide organization and cooperation betwen all levels of health facilities, health care providers, together with education of practitioners, midwifes, obstetrics and gynecology specialists, weekly evaluation of citywide high risk pregnancies and providing 7/24 online consultation of high risk deliveries resulted in a significant decrease in MMR and MNMR.