Proportion of Maternal Near Misses and Associated Factors in Referral Hospitals of Amhara Regional State, Northwest Ethiopia: Institution Based Cross Sectional Study

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Introduction: Maternal near misses are one of the quality indicators of obstetric care beside maternal deaths. According to United Nations Fund for Population Activity report in 2011, for each maternal death 20 others suffer due to maternal near misses in the world. Objective: The study was aimed to assess the prevalence of maternal near misses and associated factors in Amhara Regional State Referral Hospitals, Northwest Ethiopia. Methods: An Institution based cross sectional study was conducted from March 1, 2013 to August 30, 2013. During the study systematically selected 806 mothers who visited the maternal health care services at three Amhara Regional State Referral Hospitals were included. The data were collected through face to face interviews and direct concealed observations using pre-tested and structured questionnaires. We have used Epi Info 3.5.3 and SPSS for windows version 20 software for data entry and computing descriptive and analytical statistics respectively. To control the confounding factors, multiple logistic regression models were employed. Results: The study revealed the overall proportion of maternal near miss was 23.3 % (95% CI = 20%, 26%). No formal education (AOR = 2.00,95%CI:1.09,3.69), ≥ 7 days of hospital stay (AOR = 2.49, 95% CI: 1.46,4.25), not booked (AOR = 2.51,95% CI: 1.50,4.20), presence of administrative related factors (AOR = 3.85,95% CI 2.11, 7.03), personal factors (AOR = 4.02,95% CI: 2.34, 6.90), community related factors (AOR = 3.28,95% CI 1.67, 6.46) and medical personnel related factors (AOR = 7. 02 95% CI: 3.89,12.65) were significantly associated with maternal near misses. Conclusion and recommendations: This study indicates that the prevalence of maternal near miss is high. Reduction in maternal near miss might be best achieved through strengthening high-quality maternal health care services, designing a health program which attracts women with little or no education, and investing in health promotion, education and advocacy.