Background
Zambia has a high maternal death rate. A widely recommended tool for addressing this is to use maternal death audits. This means reviewing death cases related to pregnancy or childbirth, in order to understand what factors led to the woman dying. Medical staff can also look at so-called near-miss cases, where the woman came close to dying but eventually survived. Learning from the maternal death cases and near-miss cases can help the medical staff reflect and improve their practices going forward. The University Teaching Hospital (UTH) in Lusaka is a central referral hospital connected to smaller clinics in Chongwe and Lusaka districts. The staff at UTH conduct maternal death reviews, but the results are not communicated to the clinics in the district.

About the project
This project was created to reduce the high maternal mortality ratio in Zambia by communicating maternal death audit results from UTH to the clinics in Lusaka and Chongwe districts. The project team established a system where maternal health coordinators from the clinics attended the maternal death and near-miss audits at UTH, to review the cases together. The results were then given to the clinics and discussed at their monthly dissemination meetings.

Results
By the end of the project, monthly maternal death reviews took place at UTH and the results were given to the clinics for discussion. The results of the reviews showed that 70% of the maternal deaths in the area were caused by HIV/AIDS. The two other major causes of death were severe bleedings after childbirth (also known as postpartum hemorrhage) and eclampsia, a pregnancy-related disorder which causes seizures.

Year: 2008/2009