Abstract
BackgroundAntenatal care (ANC) provides an opportunity to prevent, identify and intervene maternal health problems. Maternal near miss (MNM), as an indicator of maternal health, is increasingly gaining global attention to measure these problems. However, little has been done to measure the effect of ANC on MNM in Ethiopia. Therefore, this study is aimed at determining the effect of ANC on MNM and its associated predictors at Gamo Gofa zone, southern Ethiopia.MethodsEmploying a retrospective cohort study design, 3 years data of 1440 pregnant mothers (480 ANC attendant and 960 non-attendant) were collected from all hospitals in the zone. Taking ANC visit as an exposure variable; we used a pretested checklist to extract relevant information from the study participants’ medical records. Characteristics of study participants, their ANC attendance status, MNM rates and associated predictors were determined.ResultsTwenty-five (5.2%) ANC attendant and seventy-one (7.4%) non-attendant mothers experienced MNM, (X2 = 2,46, df = 2, p = 0.12). The incidence rates were 59.6 (95% CI: 40.6–88.2) and 86.1 (95%CI: 67.3–107.2)/1000 person-years for the ANC attendant and non-attendant mothers, respectively. Mothers who were living in rural areas had higher hazard ratio of experiencing MNM than those who were living in urban areas, with an adjusted hazard ratio (AHR) of 1.68 (95% CI, 1.01, 2.78).ConclusionANC attendance tended to reduce MNM. However, late initiation and loss to follow-up were higher in the current study. Therefore, on time initiation and consistent utilization of ANC are required.
Highlights
Antenatal care (ANC) provides an opportunity to prevent, identify and intervene maternal health problems
Loss-of follow-up was less prevalent among mothers who initiated ANC visits during their 1st trimester compared to those who started ANC visits during their 2nd and 3rd trimesters, (Fig. 1)
Mothers who were living in rural areas were two times more likely to experience Maternal near miss (MNM) than who were living in urban areas with the crude hazard ratio (CHR) of 1.97
Summary
Antenatal care (ANC) provides an opportunity to prevent, identify and intervene maternal health problems. Maternal near miss (MNM), as an indicator of maternal health, is increasingly gaining global attention to measure these problems. Little has been done to measure the effect of ANC on MNM in Ethiopia. This study is aimed at determining the effect of ANC on MNM and its associated predictors at Gamo Gofa zone, southern Ethiopia. Maternal near miss is an important indicator of maternal health status. Though maternal mortality has so far been considered as the main critical measure of maternal health status, recent research initiatives tend to focus on maternal morbidity. It is more prevalent than maternal mortality in all countries though it is disproportionately higher in developing countries [5,6,7]. Countries with high maternal mortality have large burden of MNM [13, 14]. In Liberia it was six times more common than maternal mortality [15]
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