Delay in maternal near miss case and associated factors among women admitted in Felege Hiwot comprehensive specialized hospital, Northwest Ethiopia

Abstract Background: The current discrepancies in maternal mortality and near miss cases of high and low income countries are usually due to the differences in timely management of obstetric complications and the differences in time management comes up with idea of delay in receiving obstetric care. For each maternal death there will be 20 others that suffer as maternal near miss cases worldwide. This study aimed to assess delay of maternal near miss (MNM) and associated factors among women in Felege Hiwot Comprehensive Specialized Hospital (FHCSH), Northwest Ethiopia. Methods: Cross sectional facility based study was conducted among 287 women who were managed as MNM from May 2018 to September 30, 2018. A checklist and structured questionnaire was used to retrieve information from the patient and her medical document. The collected data was cleaned, coded and entered for analysis. The results were presented in tables. Binary and multiple logistic regression analysis were calculated at 95 % CI.Results: There were 2694 patients admitted in wards in the study period and proportion of maternal near miss was 10.65% with maternal near miss mortality ratio of 31.9 and mortality index of 3%. From all maternal near misses studied 44.3% had first delay and 35% had second delay with 51.2% had third delay. Seventy four percent of them had at least one delay. Determinant factors identified were rural residence [AOR, 3.2 P = 0.001], distance more than 10 Kms away from hospital [AOR, 2.18, p =0.025], lack of ambulance [AOR, 3.9 P= 0.009] and lack of awareness on obstetric complications [AOR,27.9, p = 0.001] which were statistically associated with any maternal delay. Conclusion: Maternal near miss proportion is still high in study site and majority of them had at least one delay in receiving care which needs an intervention at community and low level health institutions.