Determinants of Maternal Near-Miss in Ethiopia: The Implication for the First and Second Delays in the Health-Seeking

Maternal near miss refers to a very ill pregnant or delivered woman who nearly died but survived a complication during pregnancy, childbirth, or within 42 days of termination of pregnancy. In Ethiopia, in spite of all efforts, the maternal mortality rate remains unacceptably high. Thus, the study was aimed to identify the determinants of maternal near-miss among admitted women and their implications for the first and second delays in health-seeking. An unmatched case-control study was conducted from August to October 2021 among 248 (83 cases and 165 controls) women admitted for obstetric care at Gedo General Hospital. Cases were selected consecutively, whereas controls were selected randomly. Data were gathered using a structured questionnaire. Descriptive statistics were presented using tables, figures, and texts. Binary and multivariable logistic regression was done to identify determinants of the maternal near miss at p-value <.05 and 95% confidence interval. Monthly income [AOR: 0.11; 95% CI: 0.02, 0.48], decision to seek health facility [AOR: 4.54; 95% CI: 1.56, 13.21], time it takes to reach near health facility [AOR: 6.95; 95% CI: 2.29, 21.01], and birth preparedness and complication readiness [AOR: 4.1; 95% CI: 1.59, 10.58] were the determinants of maternal near miss. Monthly income, time it takes to reach a nearby health facility, and birth preparedness and complication readiness were identified as determinants of maternal near miss in this study. Therefore, policymakers and other concerned parties are recommended to improve socio-demographic development, enhance access to health care, counsel on health-seeking behavior, birth preparedness, and complication readiness to minimize the maternal near-miss.