Abstract
BACKGROUND: Maternal mortality is a significant global issue, but maternal morbidity, leading to lasting disability, is more prevalent. The World Health Organization (WHO) developed the Maternal Near Miss (MNM) tool to complement maternal mortality measures and improve maternal health outcomes. OBJECTIVE: This study compares MNM incidence and magnitude between a secondary health facility and a tertiary health facility in Abuja, Nigeria. METHODS: A 12-month prospective study identified MNM cases using WHO clinical criteria. Data on MNM cases were collected and analyzed using descriptive and comparative statistics. The chi-square test and rate ratio analysis were employed to compare MNM incidences between the facilities. RESULT: The secondary health facility had 1,340 live births, 148 MNM cases (110.5 per 1,000 live births), and 2 maternal deaths (mortality index of 1.33%) while the tertiary health facility had 796 live births, 220 MNM cases (276.4 per 1,000 live births), and no maternal deaths (mortality index of 0). Significant differences were observed in the distribution of MNM cases as rate ratio analysis showed women at the tertiary facility were 2.5 times more likely to experience MNM compared to those at the secondary facility [Rate Ratio = 2.53; 95% CI: [1.98-3.24]; p < 0.05]. DISCUSSION: The higher MNM incidence at the tertiary facility likely reflects its role as a referral center for high-risk cases. Despite higher MNM rates, the tertiary facility's effective management prevented maternal deaths, contrasting with the secondary facility's mortality outcomes. CONCLUSION: This study reveals significant disparities in MNM incidence and distribution between secondary and tertiary healthcare facilities in Abuja, Nigeria. The higher MNM incidence at the tertiary facility underscores its crucial role in managing severe maternal complications and high-risk cases, reflecting the challenges faced by secondary facilities in handling complex maternal health issues.