Summary

Medical or clinical audit has become an acquired concept in the context of obstetric and other health care in industrialised countries, but experience in developing countries is scant. In this paper, I will introduce some important concepts and principal methods of audit by examining some of the best known examples of audits in the context of obstetric care. These examples include approaches that aim at assessing and improving obstetric care at national level such as the Confidential Enquiries into Maternal Deaths, as well as facility-based methods such as case note reviews and criterion-based audits. Lessons are drawn for application to developing countries, and examples of audit experiences in developing countries are presented. Finally, the big, and as yet unanswered question of whether audit can improve care, let alone obstetric care, is addressed briefly.