Two hundred ninety six (296) women completed the interview making the response rate of 98.7%.
Socio-demographic variables
From 296 study participants involved in the study, 240(81.1%) women age is between 20-34 years with the mean age of 25.1(±5.2). Two hundred seventy (91.2%) women are married, 188(63.5%) are Oromo ethnic group and the majority of the study participants accounting 74.7% are housewives (Table 1).
Table 1: Shows the distribution of socio-demographic characteristics of study participants in public hospitals of Bale Zone, 2019.
Variables
|
Frequency
|
Percentage (%)
|
Age of respondent
<20 Years
20-34 years
>34 years
|
41
240
15
|
13.9
81.1
5.1
|
Marital status of respondents
Married
Single/Divorced/widowed
|
270
26
|
91.2
8.8
|
The ethnicity of the respondents
Oromo
Amhara
Others
|
188
88
20
|
63.5
29.7
6.8
|
Religion
Muslim
Orthodox
Protestant/Catholic
|
129
105
62
|
43.6
35.5
20.9
|
Occupation of the respondents
Housewife
Farmer
Government employee
Others *
|
221
18
17
40
|
74.7
6.1
5.7
13.5
|
Educational status of women
Unable to read and write
Able to read and write
Primary school
Secondary school
Above secondary school
|
54
60
101
50
31
|
18.2
20.3
34.1
16.9
19.5
|
Income of the women
Low
Moderate
High
|
61
165
70
|
20.6
55.7
23.6
|
Husbands educational status
Unable to read and write
Able to read and write
Primary school
Secondary school
Diploma and above
|
49
12
81
103
51
|
16.6
4.1
27.4
38.8
17.2
|
Residence area of the respondents
Rural
Urban
|
157
139
|
53
47
|
Distance from health facility
<10km
>10km
|
126
170
|
42.6
57.4
|
Others *= student, daily laborer merchant, private employee and unemployed.
Obstetrics related variables
About 233 (78.7%) of our study participants were booked for antenatal care (ANC) service and 173 (58.4%) were self-referred. From a total of 296 study participants, 211 (71.3%) reported that the current pregnancy is planned and wanted whereas regarding parity 130 (43.9%) of the participants were multiparous (Table2).
Table 2: Shows the distribution of obstetrics related variables in public hospitals of Bale Zone, Southeast Ethiopia, 2019.
Variables
|
Frequency
|
Percentage (%)
|
ANC history
Booked
Not booked
|
233
63
|
78.7
21.3
|
Number of ANC visit
First visit
Second visit
Third visit
Fourth visit
More than four visit
|
43
56
68
38
28
|
18.5
24.0
29.2
16.3
12.0
|
Type of ANC visit
First visit
Repeat visit
|
44
189
|
18.9
81.1
|
Source of referral
Self-referred
Health facility
|
173
123
|
58.4
41.6
|
Type of pregnancy
Planned and wanted
Others
|
211
85
|
71.3
28.7
|
Parity of the women
Primiparous
Multiparous
Grand multiparous
|
136
130
30
|
45.9
43.9
10.1
|
Gestational age
Unknown
<27 weeks
28-36 weeks
37-42 weeks
>42 weeks
|
21
37
20
214
4
|
7.1
12.5
6.8
72.3
1.4
|
Duration of labor
Less than 24 hours
More than 24 hours
|
253
43
|
85.5
14.5
|
Type of complication
Obstructed labor
HDP
Abortion
Hemorrhage
Sepsis
No complication
Others
|
14
26
30
10
12
192
12
|
4.7
8.8
10.1
3.4
4.1
64.9
4.1
|
Type of care providers
Specialist/ emergency surgeon
Midwife
General practitioner
|
55
206
35
|
18.6
69.6
11.8
|
Duration of hospital stay
Less than 7 days
More than 7 days
|
238
58
|
80.4
19.6
|
Administrative and medical personnel related variables
Out of 296 study participants, 8 (2.7%) reported that there was a power supply problem during their hospital stay, 22 (7.4%) encountered delay in decision making and 47(15.9%) reported that there was a delay in receiving care (Table 3).
Table 3: Distribution of administrative and medical personnel related variables in public Hospitals of Bale zone, Southeast Ethiopia, 2019.
Variables
|
Frequency
|
Percentage (%)
|
Presence of a power supply problem
Yes
No
|
8
288
|
2.7
97.3
|
Lack of transportation
Yes
No
|
18
278
|
6.1
93.9
|
Lack of lifesaving materials
Yes
No
|
12
274
|
4.1
95.9
|
Availability of blood product
Yes
No
|
144
152
|
48.6
51.4
|
Presence of delay in decision making
Yes
No
|
22
274
|
7.4
92.6
|
Presence of delay in receiving care
Yes
No
|
47
249
|
15.9
84.1
|
Presence of senior care provider
Yes
No
|
86
210
|
29.1
70.9
|
Prevalence of maternal near-miss
From the five parameters used to measure the occurrence of MNM 22(7.4%), women encountered severe hemorrhage leading to shock. Also, 48 (16.2%) of our study participants developed pregnancy-induced hypertension with a clinical or laboratory indicating termination of pregnancy to save the life of mothers. The overall prevalence of MNM is 85 (28.7%) (Table 4).
Table 4: Shows the prevalence of MNM in public hospitals of Bale Zone Southeast Ethiopia, 2019.
Variables
|
Frequency
|
Percentage (%)
|
Severe hemorrhage
Yes
No
|
22
274
|
7.4
92.6
|
Severe pre-eclampsia or eclampsia
Yes
No
|
48
248
|
16.2
83.8
|
Dystocia
Yes
No
|
8
288
|
5.1
94.9
|
Sepsis
Yes
No
|
15
281
|
5.1
94.9
|
Anemia with < 6g/dl
Yes
No
|
30
266
|
10.1
89.9
|
The overall prevalence of maternal near-miss
Yes
No
|
85
211
|
28.7
71.3
|
Factors associated with the prevalence of MNM
In binary logistic regression analysis, those variables significantly associated were exported to multivariable logistic regression analysis to control confounding factors. Those variables significantly associated in binary logistic regression are age of respondent, age at first marriage, educational status, monthly income of the respondent, husband educational status, residence area, distance from the health facility, source of referral, type of care provider, lack of transportation and delay in receiving care. Finally, age of respondent, age at first marriage, husband's educational status, and residence area are factors significantly associated in multivariate analysis after adjusting confounding factors.
Those women age less than 20 years almost 4 times more likely to develop MNM compared to their counterparts ( AOR=3.72; 95% CI: 2.68-7.11). The odds of experiencing MNM is almost 3 times more likely to encounter women with age at first marriage is less than 20 years compared to their counterpart (AOR=2.69; 95% CI: 1.32-5.48). Women whose husband educated up to primary school are 1.26 times more likely to develop MNM compared to those husbands are educated up to diploma or above (AOR=1.26; 95% CI: 1.08-2.92). Those women from rural areas are almost 2 times more likely to encounter MNM compared to those urban resident women (AOR= 1.79; 95% CI: 1.07-4.43) (Table 5).
Table 5: Bivariable and Multivariable logistic regression analysis of factors associated with the prevalence of MNM in public hospitals of Bale zone, Southeast Ethiopia, 2019.
Variables
|
MNM
|
Crude OR with 95% CI
|
Adjusted OR with 95% CI
|
Yes
|
No
|
Age of respondent
<20 years
20-34 years
>=35 years
|
10
61
8
|
31
173
7
|
3.54(1.02-12.24)
2.95(1.03-8.46)
1.00
|
3.72(2.68-7.11)*
3.88(0.90-15.52)
1.00
|
Age at first marriage
>20 years
20-34 years
|
44
41
|
82
129
|
1.69(1.02-2.81)
1.00
|
2.69(1.32-5.48)*
1.00
|
Educational status
Unable to read and write
Able to read and write
Primary school
Secondary school
Diploma and above
|
22
29
21
9
4
|
32
31
80
41
27
|
0.22(0.07-0.70)
0.16(0.05-0.51)
0.56(0.18-1.79)
0.68(0.99-2.41)
1.00
|
1.14(0.21-6.06)
1.26(0.25-6.24)
2.92(0.64-13.33)
2.56(0.59-11.16)
1.00
|
Monthly income of the respondent
Low
Middle
High
|
24
54
7
|
37
111
63
|
0.17(0.07-0.44)
0.23(0.10-0.53)
1.00
|
0.38(0.11-1.30)
0.69(0.22-2.13)
1.00
|
Husband educational status
Unable to read and write
Able to read and write
Primary school
Secondary school
Diploma and above
|
22
4
30
21
8
|
27
8
51
82
43
|
0.23(0.09-0.59)
0.37(0.09-1.54)
0.32(0.13-0.76)
0.76(0.30-1.78)
1.00
|
0.72(0.19-2.70)
0.23(0.04-1.40)
1.26(1.08-2.92)*
0.72(0.24-2.16)
1.00
|
Respondents residence area
Rural
Urban
|
60
25
|
97
114
|
0.36(0.21-0.61)
1.00
|
1.79(1.07-4..43)*
1.00
|
Distance from health facility
<10km
>10km
|
23
62
|
103
108
|
1.00
0.39(0.23-0.67)
|
1.00
1.33(0.62-2.85)
|
Source of referral
Self-referred
Health facility referred
|
62
23
|
111
100
|
0.41(0.24-0.71)
1.00
|
0.47(1.22-0.98)
1.00
|
Type of care provider
Specialist/emergency
Midwife
General practitioner
|
20
48
17
|
35
158
18
|
1.00
1.65(0.70-3.91)
3.11(1.49-6.50)
|
1.00
2.04(0.82-5.11)
1.25(0.07-1.90)
|
Lack of transportation
Yes
No
|
12
73
|
6
205
|
0.18(0.06-0.49)
1.00
|
0.06(0.01-1.33)
1.00
|
Delay in diagnosing the problem
Yes
No
|
9
76
|
38
173
|
0.20(0.08-0.50)
1.00
|
1.75(0.63-4.84)
1.00
|
NOTE: *p value is significant at p<0.05 1.00=Reference for category