A group in a developing country decided to do a survey of maternal mortality in relation to the available local facilities in the various regions of their country. They set up a small committee to look at the incidence and causes. They obtained the permission of the local authorities, including the local elders, community leaders, and local health care providers, to scrutinise records and assess aetiology and quality of care. In the paper, aggregated results are described. However, the group did not seek formal permission from the ethics committee of their associated university as they regarded the survey as an audit.
Under these circumstances, do the committee consider that formal ethics committee approval was essential and, as this was not obtained, would this preclude publication?
The discussion centred on what is an audit and the distinction between an audit and research. In the case presented here, if we are talking about an audit in terms of aggregated data, the consensus was that the editor should publish. Also, as long as every reasonable step is taken to protect the identity of the individuals, the committee believed that formal ethics committee approval was not necessary.
The paper has been accepted and will be published.