Member States share experiences in implementing "Beyond the Numbers" case reviews to reduce maternal and newborn deaths


WHO "Beyond the Numbers" (BTN) case reviews aim to improve the quality of maternal and newborn care, increase understanding of the causes of maternal deaths and severe maternal morbidity as well as to prevent the recurrence of such cases. 

A WHO meeting on the impact of BTN in improving maternal and perinatal health held on 29–30 April 2014 in Bishkek, Kyrgyzstan brought together representatives from 12 European Region Member States, United Nations Population Fund, United Nations Children’s Fund, Deutsche Gesellschaft für Internationale Zusammenarbeit, United States Agency for International Development and international experts to share their experiences of implementing these reviews.

Two BTN approaches have been introduced to varying extents in the WHO European Region: confidential enquiries into maternal deaths at national level and near-miss case reviews at facility level. The United Kingdom has more than 60 years of experience with such reviews, while a number of Eastern European countries started implementation of one or both approaches in 2005. Other Member States, including Latvia, recently joined this group. The implementation process is established with assistance of WHO and aid development partners. 

Taking stock of BTN’s impact 

Recent reports on the impact of these approaches have made it possible to summarize the impact and examine the role of BTN in improving the quality of services at facility and national levels. 

The meeting in Bishkek provided a forum for exchanging experience, clarifying many questions and developing recommendations that are useful for all countries in the European Region and beyond that have initiated implementation of BTN. Participants agreed to publish their experiences and confirmed that the biggest challenge is to maintain the quality of the audits. This requires the understanding and support of policy makers and an all-government approach, as many BTN recommendations reach beyond the health sector. 

This multi-sectorial approach is in line with the WHO European strategic framework Health 2020. It is hoped that BTN will be implemented in all countries of the Region to ensure that everything possible has been done to save lives and improve the health of women and children.