This analysis of the findings of the national confidential enquiry around maternal deaths conducted the Ministry of Health in Morocco shows that 54.3% of the deaths analysed in 2009 could have been avoided if appropriate action had been taken at health facilities.
This contradicted previous beliefs that the main causes of maternal death were due to women delaying seeking care. Lack of competence or motivation of staff were linked to the majority of cases of substandard care these women received.
The authors recommend that the managers of local health systems and practitioners themselves received the information and means to support them to implement the recommendations of the audits.
This study highlights the importance of involving hospitals and health providers in the audit process and particularly in supporting them to respond to findings.