Table 4.

The five methodologies for maternal death or disability reviews as described in ‘Beyond the Numbers’

Approach	Definition
Community-based maternal death reviews (verbal autopsies)	A method of finding out the medical causes of death and ascertaining the personal, family or community factors that may have contributed to the deaths in women who died outside of a medical facility
Facility-based maternal death review	A qualitative, in-depth investigation of the causes of and circumstances surrounding maternal deaths occurring at health facilities. Deaths are initially identified at the facility level, but such reviews are also concerned with identifying the combination of factors at the facility and in the community that contributed to the death, and which ones were avoidable
Confidential enquiries into maternal deaths	A systematic multidisciplinary anonymous investigation of all or a representative sample of maternal deaths occurring at an area, regional (state) or national level. It identifies the numbers, causes and avoidable or remediable factors associated with them
Surveys of severe morbidity (near misses)	The identification and assessment of cases in which pregnant women survive obstetric complications. There is no universally applicable definition for such cases and it is important that the definition used in any survey be appropriate to local circumstances to enable local improvements in maternal care
Clinical audit	Clinical audit is a quality improvement process that seeks to improve patient care and outcomes through systematic review of aspects of the structure, processes, and outcomes of care against explicit criteria and the subsequent implementation of change. Where indicated, changes are implemented at an individual, team or service level and further monitoring is used to confirm improvement in health-care delivery