Facility-based audit of maternal mortality in Lebanon: A feasibility study

Objective. To assess the feasibility of establishing a maternal mortality audit in Lebanon. Design. A facility-based reproductive age mortality study (RAMOS). Methods. Records of reproductive-age female deaths over an eight-year period in three hospitals in Beirut, Lebanon, were reviewed. Main outcome measures. Quality of data sources, comprehensiveness of medical charts and accessibility of information. Results. Review of records was feasible. Cross-checking three data sources identified missed cases and coding and data entry errors. The quality and accessibility of data varied between hospitals. The maternal mortality rate was 39/100,000 live births and there were 55 pregnancy-related deaths/100,000 live births. Lack of antenatal care, delay in seeking care and over-intervention on the part of the medical team were among problems identified. Conclusions. A facility based approach is a potential tool for conducting a national maternal mortality audit in a developing country like Lebanon. Computerized medical records and mandatory participation of hospitals are prerequisites for success. This would require the government to develop a cohesive national policy on reducing maternal mortality.