Towards greater effectiveness of perinatal death audit in low- and middle-income countries

This commentary paper, published in the International Journal of Gynaecology and Obstetrics in 2014, gives an overview of the effect of perinatal death audit in low- and middle-income settings. It describes the function of an outcomes audit for perinatal deaths. Buchmann postulates that where perinatal mortality is less frequent (in some middle-income countries) then reviewing near misses may be a more appropriate audit outcome.

The author discusses the two frameworks that are regularly used to assess the preventable factors for each death – the ‘three delays’ and the ‘patient-administrative-healthcare provider’ models. The latter is typically applied to middle-income settings while the former is best suited for low-income areas. Buchmann goes on to describe the criterion-based clinical audit, a popular method used to assess recurrent adverse events commonly identified in an outcomes audit. Finally, the author reviews past studies to determine the effect of change by implementing perinatal audit and to identify where there are gaps in research.