Table 4

Recommendations made by local stakeholders on how to improve NMCR quality

Hospital level
  • Ensure managerial support for the organisation of the NMCR and for the implementation of the resulting recommendations

  • Aim at regular sessions

  • Ensure active participation of all staff involved in case management, including mid-level staffing

  • Ensure that ground rules are respected

  • Ensure that the review follows the steps suggested in WHO manual9

  • Ensure that user’s views are collected and taken into consideration

  • Ensure that recommendations developed are SMART

  • Ensure that every session starts by following up on the previous recommendations

  • Document the implementation of the recommendations (provide date and description)

  • Document, analyse and disseminate results of the NMCR at hospital level, including type of recommendations developed and percentage of those implemented

National level
  • Set up/strengthen the national coordinating team

  • Develop a plan for regular quality assessment and reinforcement

  • Strengthen technical skills among staffing on the principles, methods and practices of the NMCR cycle

  • Practical training on how to conduct interviews in order to collect women’s views

  • Support networking activities among facilities (eg, exchange visits)

  • Document, analyse and disseminate results of the NMCR at national level

WHO and other development partners
  • Ensure regular and timely technical support for capacity development, including developing skills for women interviews

  • Provide support for developing legal framework and national guidance manual for NMCR

  • Support regular monitoring of the implementation in a coordinated manner

  • Support results dissemination and discussion

  • Support timely quality assessments and subsequent actions for quality improvement

  • Support networking activities among facilities/countries with the objective of improve quality of NMCR cycle

  • Ensure continuous support for updating key national guidelines, local protocols and standards for clinical practice

  • NMCR, near-miss case review; SMART, specific, measurable, achievable, realistic and time-bound.15