Situation Analysis of Maternal Near-miss in Bhutan from 2018 to 2020: Using the World Health Organization Approach.

Background: In Bhutan, the maternal mortality rate has drastically decreased over the years. In situations where maternal mortality is not a public health concern anymore, severe maternal conditions have been used as an alternative to maternal health quality indicators. Aims and

Objectives: This study aimed to report the prevalence, underlying causes, and outcomes of maternal near-miss (MNM) cases in Bhutan. Materials and

Methods: The study involved a secondary analysis of routine data on MNM cases recorded in three referral hospitals in Bhutan from 2018 to 2020. The World Health Organization MNM, 2011 approach guided the investigation.

Results: The incidence of potentially life-threatening conditions was 12.8 and MNM was 6.7 per 1000 live births. Obstetric hemorrhage, pregnancy with abortive outcomes, and hypertensive disorders in pregnancy were some of the leading conditions, which had led to women experiencing near-miss complications. About 68.5% of women had received blood products, 20.2% had undergone laparotomy, and 5.9% required intensive care unit admission.

Conclusion: An audit of MNM cases, which occur more frequently than maternal deaths, could provide better insights into the existing quality of care.