Background
Complications of pregnancy and childbirth are the leading cause of death and disability for childbearing women in many parts of the developing world, including Uganda. Clinical audits have been shown to improve the quality of health care. By auditing maternal and newborn deaths, hospital staff members can reflect on how a particular case was managed, what went right and wrong and discuss how to solve similar problems in the future in order to save more lives.

About the project
This project was created to improve the quality of maternal and newborn care at Masaka Referral Hospital, by establishing regular maternal and neonatal (newborn) audits. The project team organised sessions for health workers and the hospital administration, where they informed them about the importance of maternal and neonatal death audits when it comes to improving the care for mothers and newborns. The health workers at the hospital then participated in the design and implementation of the protocol and had regular meetings to discuss the clinical audits.

Results
By the end of the project, the number of maternal and newborn deaths had decreased slightly. The implementation of the clinical audit system was labelled a success at the hospital, as it offered a systemic, problem-solving approach to difficult clinical situations, allowing the staff to improve the quality of care. Most cases that resulted in maternal and newborn death was due to late referrals to the hospital. Going forward, the project team will continue their efforts to introduce clinical audits, but also conduct more community-based advocacy work in order to further reduce the number of maternal and newborn deaths.

Year: 2006