Maternal near misses (MNM) and their determinants among women who sought obstetric care from fort portal regional referral hospital, Western Uganda

Abstract

: Maternal near misses (MNM) involve near-death experiences and are associated with severe maternal morbidity, not limited to severe postpartum haemorrhage, sepsis and organ dysfunction. Maternal near-misses are quite common in Ugandan health facilities. This study aimed to assess the prevalence and determinants of maternal near misses among women who sought obstetric care from Fort Portal Regional Referral Hospital, western Uganda. A retrospective cohort study that targeted 375 women who had received maternal healthcare services from Fort Portal regional referral hospital was undertaken. It was found that, overall, the prevalence of MNM was 61.3%, with sepsis being the commonest determinant [187(81.3%)]. Eight individual characteristics had statistically significant relationships with MNM; residence type (p = 0.000), trimester of initiation of ANC (p = 0.000), ANC attendance (p = 0.048), delivery of recent pregnancy in health facility (p = 0.000), delivery at Fort Portal regional referral hospital (p = 0.000), referred from other facilities (p = 0.000), age (p = 0.037), marital status (p = 0.000) and district of residence (p = 0.000). The prevalence of MNM was higher among women who were of rural residence at 45.6% (aPR = 1.409 [1.330–1.493], p = 0.000), compared to those who were of urban residence. MNM prevalence was very high among mothers who never attended ANC at 3.2% and thus, less among those who had attended ANC during pregnancy (cPR = 0.652 [0.216–0.981], p = 0.048). Conclusively, the prevalence of MNM was substantially high.

Keywords:

• antenatal care
• determinants
• gravidity
• Maternal Near Misses (MNMs)
• obstructed labour
• parity

PUBLIC INTEREST STATEMENT

“Maternal near-miss (MNM)” is a condition when a woman nearly dies but survives a complication during pregnancy, childbirth or within 42 days of termination of pregnancy. MNM involves near-death experiences of mothers seeking obstetric care in health facilities. Such experiences, if not treated, can result in maternal death (MD). In Uganda, maternal near misses (MNM) occur more often than maternal deaths which could enable a more comprehensive analysis of risk factors and short-term outcomes during pregnancy and childbirth. In this study, its prevalence was up to 61.3%

Acknowledgements

The authors appreciate and acknowledge all support rendered by management of Fort Portal Regional Referral Hospital to allow us complete this study.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Contributorship

Dr Omona Kizito made the contributions related to formal analysis, data curation, investigation, supervision, validation (revising it critically for intellectual content), manuscript writing – Original Draft Preparation as well as the final approval of the version to be published.

Ms Babirye Dorothy made contributions related to conceptualization, formal analysis, investigation and methodology design and approval for publication.

Declaration

The authors declare no conflict of interest and that there was no external funding for this study

Data sharing statement

The data supporting the findings of this study are openly available in Mendeley data repository at http://doi.org/10.17632/rbwm7f8pgz.1 (Omona & Babirye, 2022).

Supplementary material

Supplemental data for this article can be accessed online at https://doi.org/10.1080/27707571.2022.2157996

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.

Notes on contributors

Kizito Omona

Kizito Omona is a Medical Doctor and Lecturer in the Faculty of Health Sciences (FHS) of Uganda Martyrs University, Kampala. He holds a PhD in Mgt [Healthcare Mgt], Master of Science in Health Services Mgt (MSc. HSM), Master of Science in Monitoring and Evaluation (MSc. M & E), Post Graduate Diploma in Project Planning and Mgt (PGD PPM), Post Graduate Certificate in Project Monitoring and Evaluation (PGC M & E), and Bachelor of Medicine and Bachelor of Surgery (MBChB) degree. He is currently engaged in teaching Public Health and Health Services Management at graduate and post-graduate Levels, Research Supervision in the said areas and levels and community engagement. Research areas are; Clinical Research, Public Health, Maternal and Child Health, Health system research and Child focused research.

Dorothy Babirye

Dorothy Babirye is a Medical Clinical Officer with Bachelor degree in Public health and health promotion (BPH-HP) and a Masters of Public Health in Populations and Reproductive Health (MPH-PRH). She currently works with Mildmay Uganda as a prevention, care and treatment officer.