Making Every Baby Count

Annex 5. Setting up a mortality
audit steering committee
The role of a steering committee in mortality audit is to organize and oversee the review
process and, when it is time to act on the findings, help develop and implement the recommendations.
The primary purpose of mortality audit is action, and without the support
of key stakeholders, recommendations cannot be turned into actions. Key stakeholders are
the people who have the responsibility and authority to achieve actions. These actions can
include community- or facility-based interventions, the development and introduction of
guidelines, improving access to services or health system reform. Thus, the importance
of the support of local community leaders, facility directors, or national or state government
entities for such audits cannot be overemphasized. Also, to ensure sustainability,
since many good programmes come to an end when project funding ends for new initiatives,
governments and other key stakeholders need to be involved from the beginning of
the facility-based death review process, informed of progress and, as appropriate, invited
to attend meetings or sit on steering committees.
Steering committee members for the facility-based death reviews (also known as “mortality
audit”) should have an interest in neonatal and maternal health. The committee should
include a diverse group of members, as appropriate. Members may include representatives
from the district health office, the facility administration, the departments of neonatology/
paediatrics, obstetrics, midwifery/nursing, anaesthesia, pathology, pharmacy and statistics,
as well as a community liaison.
The key roles of the steering committee are to:
• help initiate the case review and mortality audit process and decide on the approach and
its scope;
• oversee data collection, analysis and case selection for review meetings, including
assigning responsibility for this task if not included in existing job descriptions;
• develop a schedule for the audit meetings, invite participants and ensure adequate
facilitation;
• assist with dissemination of recommendations and advocate for their implementation.
At the national level, a stillbirth and neonatal mortality audit steering committee would
have similar composition and roles as described above, but would likely be led by
the national ministry of health, with official representation from health professional
associations, and with more opportunity for diversity of membership, including epidemiologists,
staff of nongovernmental organizations, development partners and high-level
policy-makers.
MAKING EVERY BABY COUNT: AUDIT AND REVIEW OF STILLBIRTHS AND NEONATAL DEATHS
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