Accurate record keeping in referral hospitals in Pakistan's north west frontier province and Punjab: a crucial step needed to improve maternal health.

OBJECTIVE To assess record keeping practices in referral hospitals in the North West Frontier Province (NWFP) and Punjab province, focusing specifically on United Nation's Emergency Obstetric Care (UN EmOC) indicators of maternal morbidity and mortality. METHODS This cross-sectional survey collected information at the health facility level, using UN process indicators to assess EmOC services. The study enrolled 170 health facilities from 19 randomly selected districts in Punjab and NWFP. RESULTS The study found poor record keeping practices in the health care facilities of both provinces. A few facilities had no records at all; information on obstetric complications was inconsistent. Many facilities' records were marked by duplications, inaccuracies, and data was deficient. CONCLUSION Health policies and planning in any country depend heavily on having correct and timely information on health parameters. In Pakistan, many recording and data collection problems can be solved by having well-designed and accurately maintained data registers. Proper and regular supervision and staff training are invaluable components of data collection. Efforts to improve record keeping may provide a low-cost, low-technology way to document progress towards improving maternal health.