Related Experiment Video
Updated: Jul 7, 2026

A Novel Method for Involving Women of Color at High Risk for Preterm Birth in Research Priority Setting
Published on: January 12, 2018
The use of audit to identify maternal mortality in different settings: is it just a difference between the rich and
Jeroen van Dillen1, Jelle Stekelenburg, Joke Schutte
1Department of Obstetrics and Gynaecology, Leiden University Medical Centre, Albinusdreef 2, 2333ZA Leiden, The Netherlands. gwamupanda@caiway.nl
Objective:
To illustrate how maternal mortality audit identifies different causes of and contributing factors to maternal deaths in different settings in low- and high-income countries and how this can lead to local solutions in reducing maternal deaths.
Design:
Descriptive study of maternal mortality from different settings and review of data on the history of reducing maternal mortality in what are now high-income countries.
Settings:
Kalabo district in Zambia, Farafenni division in The Gambia, Onandjokwe district in Namibia, and The Netherlands.
Population:
Population of rural areas in Zambia and The Gambia, peri-urban population in Namibia and nationwide data from The Netherlands.
Methods:
Data from facility-based maternal mortality audits from three African hospitals and data from the latest confidential enquiry in The Netherlands.
Main Outcome Measures:
Maternal mortality ratio (MMR), causes (direct and indirect) and characteristics.
Results:
MMR ranged from 10 per 100,000 (The Netherlands) to 1,540 per 100,000 (The Gambia). Differences in causes of deaths were characterized by HIV/AIDS in Namibia, sepsis and HIV/AIDS in Zambia, (pre-)eclampsia in The Netherlands and obstructed labour in The Gambia.
Conclusion:
Differences in maternal mortality are more than just differences between the rich and poor. Acknowledging the magnitude of maternal mortality and harnessing a strong political will to tackle the issues are important factors. However, there is no single, general solution to reduce maternal mortality, and identification of problems needs to be promoted through audit, both national and local.
Related Concept Videos
Regression Toward the Mean
Bias in Epidemiological Studies
Methods Of Healthcare Delivery System
Managed Care System:
The managed care system is designed to control the cost while maintaining the quality of care. The patient's care from admission to discharge is planned by the primary care provider or the case manager, also known as the gatekeeper. In a managed care system, the number of care providers is limited...
Comparing the Survival Analysis of Two or More Groups
Systematic Error: Methodological and Sampling Errors
Sampling errors originate from improper sampling methods or the wrong sample population. These errors can be minimized by refining the sampling strategy. Defective instruments or faulty calibrations are the sources of instrumental...
Respiratory Assessment: Purpose and Indications
Objectives and Importance:
The primary goal of respiratory assessment is to evaluate patients at early risk of clinical deterioration. Since respiratory distress often precedes other signs of declining health, breathing patterns and sounds become a...