Ž . International Journal of Gynecology & Obstetrics 59 Suppl. 2 1997 S149S155 Improving recordkeeping for maternal mortality programs, Kumasi, Ghana J.B. Danquah a,  , E.K. Appah b , J.O. Djan b , M. Ofori a , I.T. Essegbey a , S. Opoku a , Ž . The Kumasi PMM Team a Ministry of Health, Kumasi, Ghana b Ministry of Health, School of Medical Sciences, Kumasi, Ghana Abstract Preliminary studies: Data on obstetric complications are the basis of monitoring maternal mortality interventions in the PMM Network. A review of recordkeeping procedures at 10 facilities in the study area revealed that information on obstetric complications was often inconsistent or missing. Some hospital records were not designed to collect such information at all. Interentions: In 1992, registers at facilities were revised to collect information on complications and time of treatment. Doctors, nurses, midwives and clerks were trained to record, compile and analyze data. Monitoring and supervisory mechanisms were also set up. Results: Recordkeeping has improved. Data collection and analysis have been regular and timely. Doctors have begun using the data for morning meetings. Nurses and midwives compile monthly summaries of data showing complications by type. Two other districts outside the research area have adopted the reporting system and it is possible that facilities in the whole region will follow suit. Costs: The cost of improving recordkeeping at the 10 healthcare facilities was approximately US $2543, with 85% coming from project funds. Conclusions: Existing recordkeeping systems can be modified to collect data necessary to monitor maternal mortality interventions. Staff training and monitoring visits are important to success.  1997 International Federation of Gynecology and Obstetrics Keywords: Africa; Ghana; Maternal mortality; Obstetric services; Records; Training; Cost 1. Introduction The launching of the Safe Motherhood Initia- tive in 1987 encouraged many international groups  Corresponding author, Ministry of Health, Box 1908, Ku- masi, Ghana. to propose a variety of strategies to address the problem of maternal mortality. In the last five years, one of the big changes in the Initiative has been the increasing emphasis on obstetric compli- cations as the key point of intervention. During that time, there has been a growing acceptance that, although most obstetric complications can- not be predicted or prevented, they can be treated. 0020-729297$17.00  1997 International Federation of Gynecology and Obstetrics Ž . PII S0020-7292 97 00160-4