{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,18]],"date-time":"2025-12-18T09:07:27Z","timestamp":1766048847084,"version":"3.37.3"},"reference-count":31,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2017,6,5]],"date-time":"2017-06-05T00:00:00Z","timestamp":1496620800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Aust NZ J Obst Gynaeco"],"published-print":{"date-parts":[[2017,12]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Maternal near\u2010miss indices are World Health Organisation (<jats:styled-content style=\"fixed-case\">WHO<\/jats:styled-content>) recognised indicators that may improve our understanding of factors associated with maternal morbidity and mortality. In Papua New Guinea (<jats:styled-content style=\"fixed-case\">PNG<\/jats:styled-content>) where maternal mortality is among the highest in the world, only one study has documented near\u2010miss indices in a tertiary\u2010level hospital, but none from provincial hospitals where the majority of under\u2010privileged women access healthcare services.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>To determine the near\u2010miss ratio, maternal mortality index (<jats:styled-content style=\"fixed-case\">MMI<\/jats:styled-content>), and associated maternal indices for Modilon Hospital in Madang Province of<jats:styled-content style=\"fixed-case\">PNG<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>All women attending Modilon Hospital who met the<jats:styled-content style=\"fixed-case\">WHO<\/jats:styled-content>maternal near\u2010miss definition and\/or a<jats:styled-content style=\"fixed-case\">WHO<\/jats:styled-content>\u2010modified (<jats:styled-content style=\"fixed-case\">PNG<\/jats:styled-content>\u2010specific) near\u2010miss definition, were prospectively enrolled.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There were 6019 live births during the audit period; 163 women presented with life\u2010threatening conditions (153 near\u2010misses and 10 maternal deaths). The maternal near\u2010miss ratio was 25.4\/1000 live births and the maternal mortality ratio (<jats:styled-content style=\"fixed-case\">MMR<\/jats:styled-content>) was 166\/100\u00a0000 live births, with a maternal death to near\u2010miss ratio of 1:15.3. The severe maternal outcome ratio was 27.1\/1000 live births and the total mortality index was 6.8%. Higher proportions of near\u2010miss women were aged \u226530\u00a0years, nulliparous, illiterate, from rural communities, lacked formal employment, referred from peripheral health facilities, unbooked, had history of still births and were anaemic.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Sociodemographic factors such as women's rights, education level and status in society, in addition to appropriate health reforms with greater financial and political support are urgently needed to ensure underprivileged women in rural<jats:styled-content style=\"fixed-case\">PNG<\/jats:styled-content>have access to family planning, supervised deliveries and skilled emergency obstetric care.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ajo.12650","type":"journal-article","created":{"date-parts":[[2017,6,5]],"date-time":"2017-06-05T08:06:40Z","timestamp":1496650000000},"page":"624-629","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Maternal near\u2010misses at a provincial hospital in Papua New Guinea: A prospective observational study"],"prefix":"10.1111","volume":"57","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1214-9817","authenticated-orcid":false,"given":"John W.","family":"Bolnga","sequence":"first","affiliation":[{"name":"Modilon Hospital Madang Papua New Guinea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marilyn","family":"Morris","sequence":"additional","affiliation":[{"name":"Modilon Hospital Madang Papua New Guinea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Catherine","family":"Totona","sequence":"additional","affiliation":[{"name":"Modilon Hospital Madang Papua New Guinea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Moses","family":"Laman","sequence":"additional","affiliation":[{"name":"Department of Paediatrics Modilon Hospital Madang Papua New Guinea"},{"name":"Papua New Guinea Institute of Medical Research Madang Papua New Guinea"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2017,6,5]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMp1012860"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(16)31470-2"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2012.03294.x"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/bmb\/ldg007"},{"volume-title":"Evaluating the Quality Of Care For Severe Pregnancy Complications. 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