Anthropological insights about a tool for improving quality of obstetric care: The experience of case review audits in Burkina Faso

Abstract

The ratio of maternal morbidity and mortality in developing countries is high. The World Health Organization (WHO) and public health specialists promote case review audits as a means of improving quality of obstetric care. This reflects the need for high reactivity in health personnel's management of obstetric complications. Within an action-research programme in Burkina Faso, a trial of case review audits was implemented in a maternity ward. This was designed to help health personnel bett er align their practice with clinical standards and to enable more consideration of pregnant women's needs. Social anthropologists were involved in these case review audits in order to collect data about pregnant women's lifestyles and circumstances. They also worked to train health personnel to conduct interviews. Although it is important to take account of women's circumstances within audit sessions, conducting interviews in 'anthropological ways' (at women's homes, with observations) is time consuming and may sometimes be bett er replaced with interviews in hospital contexts. Anthropologically informed interviews may pinpoint socio-economic situations as key reasons for problems in healthcare, but health personnel are usually powerless to address these. However, anthropology contributes an awareness of the relevance of these issues for broader healthcare planning. © Berghahn Books and the Association for Anthropology in Action.