Lived experiences of maternal near misses: a qualitative study in the Kilimanjaro Region, Tanzania.

Abstract

Background: In recent years, Tanzania has significantly reduced maternal mortality rates; however, pregnant women in Tanzania still face severe health risks and complications. The rate of maternal near misses is nearly 60% higher in Tanzania compared to other low-income countries. Women who survive severe complications during pregnancy or childbirth may experience long-lasting adverse effects, such as poor physical health, impaired sexual function, psychological distress, and a decreased quality of life. Therefore, our research aimed to understand the lived experiences of Tanzanian women who survived severe maternal complications within their cultural and social context.

Method: By using the Sub-Saharan Africa criteria for near misses, twelve (12) women who survived severe maternal complications were recruited between August and September 2022. The study utilized a descriptive qualitative design with an inductive approach to explore women's lived experiences of a maternal near miss. The participants were purposively sampled and interviewed face-to-face in the hospital or their homes six weeks after discharge from the hospital. Recorded interviews were transcribed and analysed using Graneheim and Lundman's content analysis.

Results: The analysis revealed four themes and eight subthemes. The themes were living with severe maternal complications, impact on social life, perception of obstetric care services and person-centred care. The informants described pain experiences, weakness, fear, financial difficulties, neglect, long waiting times, and a lack of information. However, they also mentioned a need for increased awareness of danger signs, care satisfaction, and the importance of close relatives' social support.

Conclusion: Maternal near misses have a great impact on women's physical, financial, and mental well-being. Women also experience long service waiting times, communication barriers, and neglect. Good healthcare, person-centred care, patient education, and psychological support can improve women's lived experiences.