Determinants of Maternal Near Miss in Kenya: A Secondary Analysis of Data From a Nationally Representative Study.

Abstract

Maternal mortality is a significant public health issue that disproportionally affects low- and middle-income countries, including Kenya. Despite recent efforts by the Kenyan government to improve obstetric outcomes, the maternal mortality ratio remains high at 530 deaths per 100,000 live births. The World Health Organization defines maternal near miss (MNM) as 'a women who nearly died but survived a complication that occurred during pregnancy, childbirth or within 42 days of termination of pregnancy'. It is becoming increasingly recognised that MNM and maternal morbidity are better outcome indicators for evaluating the quality of obstetric care, in comparison to maternal mortality. This is due to maternal deaths being considered as only the tip of the iceberg, with the true burden of maternal morbidity being much greater. MNM events occur much more frequently than maternal deaths, and with similar causes and characteristics, can provide invaluable evidence about the factors related to maternal mortality. The Three Delays Model defines three pivotal stages that impact obstetric outcomes: delays in seeking, reaching, and receiving care. The aim of this study is to investigate the determinants of maternal near miss among women admitted to hospitals across Kenya, including the Three Delays Model, using a nationally representative sample.