Maternal mortality surveillance in an inland Chinese province

Objectives: To evaluate the Chinese maternal mortality surveillance system in an inland province and identify how it can be improved. Methods: The review process and Chinese Maternal Deaths Reporting Form were compared with standards recommended by the UK Confidential Enquiry into Maternal and Child Health using interviews with key personnel, field observations, and reports and audits from 2003–2005. Results: The Chinese Maternal Deaths Reporting Form does not provide anonymity for the deceased woman, the health workers, or hospitals. The information collected is often insufficient to identify substandard care. The Review Committee was not multidisciplinary and the review was not confidential. The review findings were only available to the Review Committee. Conclusion: Confidentiality should be a requirement in the maternal mortality surveillance system. The anonymous findings should be available to health workers, and be used to improve the system and inform the community about performance.