Healthcare in Low-resource Settings 2024; volume 12:12474 Determinants of maternal near-miss among women admitted to public hospitals in the Hadiya zone, central Ethiopia: a case-control study Samuel Kusheta, 1 Gurmesa Tura, 2 Afework Tadele, 2 Wudu Yesuf 3 1 Department of Public Health, Hossana College of Health Sciences; 2 Population and Family Health Department, Faculty of Public Health, Institute of Health, Jimma University; 3 Department of Public Health, Mizan-Aman College of Health Sciences, Aman, Ethiopia Abstract One of the Sustainable Development Goals of the United Nations is to bring the global maternal mortality ratio down to less than 70 per 100,000 live births by 2030. Therefore, pinpointing the factors that influence maternal near-misses would help expe- dite the accomplishment of this goal. Studies on these topics are, nevertheless, scarce in the Hadiya zone and throughout Ethiopia as a whole. Therefore, the purpose of this study was to determine the factors that contribute to maternal near-misses among women who are admitted to public hospital maternity wards in the Hadiya zone in central Ethiopia. A facility-based, unmatched case-control study was conducted from February 17 to August 16, 2019. The study covered all secondary and tertiary public healthcare facili- ties in the Hadiya zone, which includes three district hospitals and one referral hospital offering comprehensive emergency obstetric care services. The study included 279 women in total (70 cases and 209 controls). Mothers who had had a near-miss were the cases, and mothers who had not had one were the controls. The Statistical Package for Social Sciences version 24 was used to analyze the data, and the multivariable binary logistic regression model was used to control confounders. The odds ratios (OR) and 95% confidence intervals (CI) were used to determine statistical significance at a p-value of less than 0.05. Living in a rural area [adjusted OR (AOR)=3.16; 95% CI: 1.62, 6.16], no birth pre- paredness (AOR=3.50; 95% CI: 1.66, 7.41), ever gave birth by cesarean section (AOR=3.68; 95% CI: 1.63, 8.31), previous histo- ry of hypertension (AOR=3.69; 95% CI:1.52, 8.96), and poor knowledge of pregnancy danger signs (AOR=3.15; 95% CI: 1.32, 7.52) were all determinants of maternal near-miss. Thus, strength- ened public health and clinical interventions in these arenas need to prioritize rural women and women with a previous history of hypertension. Introduction Despite a 44% decrease in the maternal mortality ratio since 1990, ending preventable maternal death continues to be one of the world’s most pressing challenges. Even though this is a notable improvement that demonstrates what is possible with con- tinued effort, the world fell short of the 75% reduction target set by Millennium Development Goal 5. 1 Maternal deaths are uncom- mon in terms of absolute numbers per center, despite the high maternal mortality ratios in many resource-poor settings. As a result, there is less statistical power available for research to examine potential risk factors and contextual determinants. 2 Because maternal near-misses (MNM) occur more frequently than maternal deaths, in this case, they could be used as a stand-in for maternal deaths to assess the quality of obstetric care in specific healthcare facilities. 3,4 Moreover, it presents a favorable prospect for gathering data because women themselves can serve as infor- mation sources. 5 The World Health Organization (WHO) request- ed more research on MNM in light of these facts. 6,7 MNM is Correspondence: Samuel Kusheta, Department of Public Health, Hossana College of Health Sciences, Hossana, Ethiopia. Tel.: +251-934774841. E-mail: kushetasamuel@gmail.com Key words: determinant factors, maternal near-miss, maternal mortality, central Ethiopia. Contributions: SK, participated in the conception and design of the study, performed statistical analyses, and wrote the first to final versions of the manuscript; GT, AT, WY, participated in the design of the study, and read and revised the draft versions of the manuscript. All authors contributed to all sections of the manuscript and approved the final version. Conflict of interest: the authors declare that they have no competing interests. Ethics approval and consent to participate: with the reference number IHRPG9/698/2019, the Jimma University Institute of Health Institution Review Board has ethically approved the study protocol. Informed consent: participants in the study provided verbal informed consent. The goal and purpose of the study, as well as the respondents’ right to withdraw from the study at any time without compromising their hospital care, were explained to the participants. An anonymous ques- tionnaire was used to ensure information confidentiality, and de-identi- fied and de-linked data was kept in a safe place. Funding: this research did not receive grants from any funding agency in the public, commercial, or not-for-profit sectors. Availability of data and materials: the datasets used and/or analyzed dur- ing the current study are available from the corresponding author upon reasonable request. Acknowledgments: the authors acknowledge Hossana College of Health Sciences for financial and material support for this research work. They also acknowledge the participating hospitals as well as study participants and data collectors for all their support during the preliminary survey, pre-test, and actual data collection. Received: 13 March 2024. Accepted: 2 April 2024. Early access: 4 June 2024. This work is licensed under a Creative Commons Attribution 4.0 License (by-nc 4.0). © Copyright: the Author(s), 2024 Licensee PAGEPress, Italy Healthcare in Low-resource Settings 2024; 12:12474 doi:10.4081/hls.2024.12474 Publisher's note: all claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organi- zations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher. [page 368] [Healthcare in Low-resource Settings 2024;12:12474] Non-commercial use only