Association between near miss maternal with sociodemographic factors and health assistants

Abstract

Abstract Objectives: evaluate the association between the maternal near miss rate (TNMM) and sociodemographic and health care factors. Methods: this is an aggregated, cross- sectional epidemiological survey, with regression analysis and spatial analysis, with the units of analysis being the 399 municipalities that make up the four health macro- regions in the state of Paraná, Brazil. Data from the years 2018 to 2021 were obtained through the state maternal near miss report and monitoring system. Results: the state’s total TNMM was 6.4 per 1,000 live births, with an increasing trend during the studied period (p<0.001). Sociodemographic and healthcare factors were not associated with TNMM, except for municipalities with a higher degree of urbanization (β adjusted=0.022; CI95%=0.002-0.041) and located in the northern health macro-region (β adjusted=12.352; CI95%= 10.779-15.099), demonstrated by clusters with high and positive associations (high-high). Conclusion: the lack of association with sociodemographic and care factors may be due to their low effect on near miss, or the underreporting of near miss cases in the state. The differences found can be justified by the organization of health services and the intense regionalization of municipalities belonging to the macronorth, which have a better near miss report culture.

Keywords

• Near miss
• Sociodemographic factors
• Quality
• access and evaluation of health care
• Regionalization of health
• Report