Document Detail

Exploring the sustainability of obstetric near-miss case reviews: a qualitative study in the South of Benin.
MedLine Citation:
PMID:  20709433     Owner:  NLM     Status:  MEDLINE    
INTRODUCTION: near-miss case reviews are one of a number of audit approaches currently being used and evaluated by those with an interest in reducing high rates of maternal mortality in developing countries. Researchers are beginning to take an interest in issues relating to the sustainability of audits.
OBJECTIVE: to develop an understanding of the barriers and facilitators to the sustainability of obstetric near-miss case reviews in five hospitals in southern Benin.
DESIGN AND METHODS: semi-structured interviews were designed to explore health workers' and policy makers' views and experiences of the sustainability of near-miss case reviews aimed to improve quality of care and reduce maternal mortality.
SETTING: five hospitals in three regions in the south of Benin.
PARTICIPANTS: two Ministry of Health officials and eight health-care workers involved in a feasibility study conducted in 1998-2001 that introduced near-miss case reviews.
ANALYSIS: framework analysis to identify themes.
FINDINGS: while all participants believed in the importance and value of audit, all hospitals had stopped performing near-miss case reviews within two years of completing the feasibility study. Ten qualitative interviews identified six themes relating to the sustainability of case reviews: clear advantages in ensuring quality of care, fear of blame and punishment, availability of resources, training, supportive hospital work environment, and broader policy issues.
KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: implementing and sustaining audit is a complex intervention that requires careful planning and consideration. It is important to consider both the content and the context in which audit takes place when developing strategies for sustainability.
Cindy Hutchinson; Isabelle Lange; Lydie Kanhonou; Veronique Filippi; Matthias Borchert
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-08-14
Journal Detail:
Title:  Midwifery     Volume:  26     ISSN:  1532-3099     ISO Abbreviation:  Midwifery     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-09-27     Completed Date:  2011-01-14     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8510930     Medline TA:  Midwifery     Country:  Scotland    
Other Details:
Languages:  eng     Pagination:  537-43     Citation Subset:  N    
Copyright Information:
Copyright © 2010 Elsevier Ltd. All rights reserved.
Infectious Diseases Epidemiology Unit, Department of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, Keppel Street, London, UK.
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MeSH Terms
Emergency Service, Hospital / organization & administration
Feasibility Studies
Infant, Newborn
Maternal Mortality / trends
Maternal Welfare
Medical Audit / statistics & numerical data*
Obstetrics and Gynecology Department, Hospital / organization & administration*
Pregnancy Complications / epidemiology,  prevention & control*
Quality Assurance, Health Care / organization & administration
Safety Management / organization & administration*

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