Factors for change in maternal and perinatal audit systems in Dar es Salaam hospitals, Tanzania

Nyamtema et al. BMC Pregnancy and Childbirth 2010, 10:29http://www.biomedcentral.com/1471-2393/10/29RESEARCH ARTICLE Open AccessResearch articleFactors for change in maternal and perinatal audit systems in Dar es Salaam hospitals, Tanzania1 2 3 2 4,5Angelo S Nyamtema* , David P Urassa , Andrea B Pembe , Felix Kisanga and Jos van RoosmalenAbstractBackground: Effective maternal and perinatal audits are associated with improved quality of care and reduction of severe adverse outcome. Although audits at the level of care were formally introduced in Tanzania around 25 years ago, little information is available about their existence, performance, and practical barriers to their implementation. This study assessed the structure, process and impacts of maternal and perinatal death audit systems in clinical practice and presents a detailed account on how they could be improved.Methods: A cross sectional descriptive study was conducted in eight major hospitals in Dar es Salaam in January 2009. An in-depth interview guide was used for 29 health managers and members of the audit committees to investigate the existence, structure, process and outcome of such audits in clinical practice. A semi-structured questionnaire was used to interview 30 health care providers in the maternity wards to assess their awareness, attitude and practice towards audit systems. The 2007 institutional pregnancy outcome records were reviewed.Results: Overall hospital based maternal ...