Evaluation of criteria-based clinical audit in improving quality of obstetric care in a developing country hospital

Afr J Reprod Health. 2008 Dec;12(3):59-70.


Study evaluated criteria-based clinical audit in measuring and improving quality of obstetric care for five life-threatening obstetric complications: obstetric haemorrhage, eclampsia, genital tract infections, obstructed labor and uterine rupture. Clinical management of 65 patients was audited using a 'before (Phase I) and after (Phase II)' audit cycle design using standard criteria. Following Phase I, areas in need of improvement were identified; mechanisms for improving quality of care were identified and implemented. Overall care of the complications improved significantly in obstetric haemorrhage (61 to 81%, p = 0.000), eclampsia (54.3 to 90%, p = 0.00), obstructed labour (81.7 to 93.5%, p < 0.001) and genital tract sepsis (66 to 85.2%, p < 0.01). Clinical monitoring, drug use, and urgent attention by senior medial staff also improved significantly after intervention. Criteria-based clinical audit is feasible and acceptable for improving management of life-threatening obstetric complications. Its application is recommended in health institutions in developing countries.

MeSH terms

  • Adult
  • Clinical Audit*
  • Developing Countries
  • Female
  • Humans
  • Maternal Health Services / standards*
  • Nigeria
  • Obstetrics / standards*
  • Pregnancy
  • Pregnancy Complications / therapy*
  • Prospective Studies
  • Quality of Health Care*