In the journal article Audit-identified avoidable factors in maternal and perinatal deaths in low resource settings: a systematic review, Hasan Merali and colleagues present the findings of a systematic review of all published audits in low and low-middle income countries in order to identify the most common avoidable factors of maternal and perinatal deaths worldwide.
Notably, the majority (two-thirds) of avoidable factors were accounted for within the category health worker-oriented factors, such as substandard practice of health workers and delay in receiving care on admission. The leading three factors of deaths were:
- substandard practice of health workers
- patient delay to seek care
- lack of capacity in blood transfusion
The review reiterates the valuable insight that audits provide in identifying systematic deficiencies in clinical care, which in turn can be used for targeting interventions to address these system failures. What’s more, the very fact that the causes of maternal and perinatal deaths are often similar in low-resource settings means that these avoidable factors could be used to inform a rational design of health systems.
Full reference: Merali, H., Lipsitz, S., Hevelone, N., Gawande, A., Lashoher, A., Agrawal, P., & Spector, J. (2014). Audit-identified avoidable factors in maternal and perinatal deaths in low resource settings: a systematic review. BMC Pregnancy and Childbirth, 14(1), 280.