Women's experiences and perceptions on the impacts of maternal near miss and related complications in Rwanda: A qualitative study

Maternal morbidity and mortality continue to emerge across the globe especially in lower-income countries. This study aimed at exploring in-depth perceptions of near-miss experiences among Rwandan women and how these experiences can be used to develop strategies for health policy implementation. Using qualitative inductive research based on grounded theory, we analyzed 27 indepth interviews that were conducted with women with documented records of maternal near-miss events. Women were knowledgeable about pregnancy complications and the benefits of antenatal care. Near-miss events that occurred either before or during hospitalization. Women recognized their own involvement their near-miss events by delaying care seeking. They also mentioned delays due to healthcare providers delaying transfers, misdiagnosing the events, and delaying to intervene even at the time the diagnosis was made. Women acknowledged the life-saving role of outreach programs and community health workers. We that pregnancy outcomes would be improved in this population of women with education on pregnancy complications, training of community health workers, and sustained mentorship program. (Afr J Reprod Health 2022; 26[5]: 63-71).

Barriers to Obstetric Care among Maternal Near Misses

Background. There are several factors in the healthcare system that may influence a woman's ability to access appropriate obstetric care.Objective. To determine the delays/barriers in providing obstetric care to women who classified as a maternal near-miss. Methods. This was a descriptive observational study at Steve Biko Academic Hospital; a tertiary referral hospital in Pretoria; South Africa. One hundred maternal near-misses were prospectively identified using the World Health Organization criteria. The 'three-delays model' was used to identify the phases of delay in the health system and recorded by the doctor caring for the patient.Results. One or more factors causing a delay in accessing care were identified in 83% of near-miss cases. Phase I and III delays were the most important causes of barriers. Lack of knowledge of the problem (40%) and inadequate antenatal care (37%) were important first-phase delays. Delay in patient admission; referral and treatment (37%) and substandard care (36%) were problems encountered within the health system. The above causes were also the most important factors causing delays for the leading causes of maternal near-misses - obstetric haemorrhage; hypertension/pre-eclampsia; and medical and surgical conditions.Conclusions. Maternal morbidity and mortality rates may be reduced by educating the community about symptoms and complications related to pregnancy. Training healthcare workers to identify and manage obstetric emergencies is also important. The frequency of antenatal visits should be revised; with additional visits in the third trimester allowing more opportunities for blood pressure to be checked and for identifying hypertension