Introducing criteria based audit into Ugandan maternity units

Abstract

Teaching of criteria based audit to those providing health care in developing countries can produce low cost improvements in the standards of care. Because the method is simple and can be used to provide improvements even without new funding, it has the potential to produce sustainable and cost effective changes in the standard of health care. Follow up is needed to prevent a waning of enthusiasm with time.

Criteria‐based audit to improve women‐friendly care in maternity units in Malawi

“…8 Criteria-based audit, which has been used for many years in the United Kingdom, has recently been introduced in developing countries. [9][10][11] Although the language of quality improvement is now being spoken in developing countries, the contribution of criteriabased audit is still minimal. 9 Furthermore, most clinical audits have focused on improving the management of emergency obstetric complications, while quality as perceived by the clients or patients seems to have been neglected.…”

Promoting accountability in obstetric care: Use of criteria-based audit in Viet Nam

“…Recent reports reflect the flexibility of CBA in the hands of creative clinicians and managers Á from a supervisor's tool in coaching and mentoring in Ayacucho, Peru (Kayongo et al 2006), to CBA with no formal data collection (Weeks et al 2003). The result is the same: dedicated staff questioning how they do things, and working together to improve performance.…”

“…Historically, audit and feedback has been used to improve clinical care in industrialised countries for many years, but only in the past 10 years has CBA been introduced in poorly resourced countries to improve obstetric practices (Graham et al 2000, Wagaarachchi et al 2001, Weeks et al 2003, Weeks et al 2005, Muffler et al 2007. The effectiveness of the audit has been called into question in industrialised countries, especially when assessed over a period of years (Berger 1998, Ronsmans 2001, Jamtvedt et al 2006.…”

Developing Standards for Postpartum Hemorrhage in a Resource-Limited Country

“…Traditionally, standards have been developed by a panel of experts and then implemented by a multidisciplinary team (Graham et al, 2000). In obstetrics, the panel of experts often is made up of obstetricians, while the rest of maternity staff such as nurses and midwives are not actively involved during the early stages of criteria-based audit (Weeks et al, 2003). We involved all grades of health professionals from the very beginning of the standards development process, and we hope that this will promote ownership and sustainability.…”

“…In earlier studies the authors assessed the feasibility of introducing criteria-based audit maternity units in developing countries (Weeks et al, 2003). Ronsmans (2001) described five challenges that could affect the implementation of audit in developing countries: (a) poor access to scientific literature, (b) the hierarchical structure of the medical profession, (c) lack of resources to support audit activities, (d) poor quality of case notes, and (e) the scale of resource constraints.…”