Assessing the maternal death audit management system at Komfo Anokye Teaching Hospital using the National (MOH) audit guidelines as reference

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Maternal death is defined as the death of a woman pregnant or within 42 days following termination of pregnancy, irrespective of duration and site of the pregnancy, from any cause related to or aggravated by pregnancy or its management but not from accidental or incidental causes. (Suleiman,1999). Medical Death Audit is an integral part of modem medicine (Irish Medical Journal, 2001). Audit is of Latin derivation, which means hearing (Arnold et al, 1992). Clinical audit is systematic and critical analysis of quality of clinical care, including the procedures used for diagnosis and treatment, the associated use of resources and the effect of care on the outcome and quality of life for the patient. Even though, maternal death is very high especially in the developing countries including Ghana, information on maternal death audits and its impact in the overall quality of health care. This study examined the Management System of Maternal Death Audit at Komfo Anokye Teaching Hospital, Kumasi. The objective of the study included examining the structure, process and outcome of maternal death audit at KATH so as to give recommendation to improving maternal death thereby reducing maternal mortality. A descriptive study with a cross-sectional design, a total of fifty management/staff was interviewed with a questionnaire. Also a checklist was designed to review one hundred and eighty nine (189) cases of maternal deaths that occurred from 2001-2003. The findings showed the average maternal mortality ratio at KATH is 9.5 1/1000 live births. There is no Maternal Audit Committee at KATH that reviews maternal deaths. In fact, it was found that meeting termed “maternal conference” are rarely organized. Such meeting was held only once. Proceedings of such meeting are not recorded neither are standard forms used to review maternal deaths. From the study, it was evident that there were no dissemination of findings of such meetings and therefore no feedback. This is at the peril of improving maternal health. ‘The practice at KATH was found to be at variance with what has been prescribed by the Ministry of Health as enshrined in the Maternal Death Audit Guidelines document, 2002. Appropriate recommendations have been made to Management, Staff and other stakeholders at KATH to improve the practice of auditing maternal death so as to reduce the high maternal mortality at the hospital.
A thesis presented to the Department of Community Health, School of Medical Sciences, College of Health Sciences Kwame Nkrumah University of Science and Technology in partial fulfilment of the requirements for the award of in Health Services Planning and Management