To evaluate the quality of maternal clinical care, Immpact, a global research initiative, developed an innovative method, called TRACE, to \"trace adverse and favourable events in pregnancy care.\" It is based on the confidential enquiry technique, whereby expert panels of health care professionals assess the quality of health care provided to clients in an adverse event, such as a maternal death.
This approach goes beyond the traditional confidential enquiry technique in several ways. First, quality of care is assessed in cases of both death and near misses (cases of life-threatening complications during pregnancy, delivery, or postpartum). Second, it identifies instances of good as well as substandard care, as opposed to assessing only substandard care as traditional enquiry panels do. Finally, the TRACE tool can be used to assess quality of care provided in community-based programmes where no medical records or case notes are kept, such as in the village midwife programme in Indonesia. This method provides a qualitative explanation of why a maternal death or near miss occurs, and can supplement quantitative assessments. The approach can be used to generate recommendations for clinical practice in developing countries.
TRACE: A New Way to Measure Quality of Maternal Health Care, Immpact, University of Aberdeen, UK, 2 pp.