The Ministry of Public Health announced on March 12 that its Near Miss strategy has led to a significant reduction in maternal mortality in the provinces of Manabí and Santo Domingo de los Tsáchilas. The initiative focuses on improving hospital responses to critical obstetric emergencies, aiming to save the lives of women at high risk during pregnancy, childbirth, or postpartum.
The Near Miss approach identifies cases where women face imminent risk of death but survive due to effective medical intervention. By analyzing these cases, health authorities seek to refine emergency protocols and improve outcomes for mothers.
In 2025, there were 11,262 live births recorded across both provinces. Of these, 369 pregnant women met the criteria for Near Miss events and received specialized treatment. The fatality rate among these cases was reported at just 1.35 percent, despite challenges such as pre-existing health conditions and delayed initial care.
The strengthened hospital network supporting this strategy includes facilities in Portoviejo (Hospital Verdi Cevallos Balda), Manta (Hospital Rafael Rodríguez Zambrano), Chone (Hospital Napoleón Dávila Córdova), Santo Domingo (Hospital Gustavo Domínguez), and Sucre (Hospital Miguel Hilario Alcívar, incorporated in 2024).
One example cited by officials is the case of Flor Lucas, a 39-year-old patient with chronic kidney failure who developed HELLP syndrome during her pregnancy. “We received a patient with several years of kidney failure and severe complications. Thanks to the rapid action of the multidisciplinary team, she is now in excellent condition,” said Marcelo Guerra, gynecologist-obstetrician at Hospital de Chone.
Melva Morales García, regional head of Health Surveillance, said that each case helps optimize coordination between emergency services, gynecology, intensive care units, and neonatology departments. To date, five clinical audits have been conducted along with ongoing training for second- and third-level healthcare staff to ensure safe and evidence-based care.
Officials say that beyond immediate assistance for patients, the strategy serves as a continuous improvement laboratory for maternal health services.
