Incidence, Causes, and Determinants of Maternal Near-Miss among Women Attending Public Hospitals in Borena Zone of Oromia Region, Ethiopia

Background: Maternal near-miss refers to an event where a woman who nearly died but survived complications that occurred during pregnancy, childbirth, or within 42 days of termination of pregnancy. Survivors of near-miss events share several characteristics with mothers who would have died. Thus, up-to-date information on the magnitude and causes of maternal near-miss is vital to improve the quality of maternal care. Methods: A facility-based cross-sectional study was conducted among women attending public hospitals in Borena zone from August 15 to November 15, 2022. All women admitted to participating hospitals during pregnancy, childbirth, or within 42 days following termination of pregnancy who met the WHO near-miss criteria were enrolled into the study. Result: Out of the total 1421 deliveries during the study period, we were able to identify 117 women that developed potentially life-threatening conditions, with 61 of these women experiencing severe maternal outcomes (55 near-misses and 6 maternal deaths). The maternal near-miss incidence ratios was estimated to be 38.7 per 1000 live births and a mortality index of 9.8%. Hypertensive disorders, 61.8% (CI: 48% - 74%), and obstetric hemorrhage, 29.1% (CI: 18% - 42%) were the leading underlying causes of maternal near-misses. Conclusion: The incidence of maternal near-miss was remarkably high when compared to previous studies. Giving special emphasis to life-saving interventions, critical care, reducing delays and improving the referral system are critical to improve quality of care.