Medical audit by peer review and competitive self-appraisal as tools for promoting efficiency: A case study in Lahore, Pakistan

A pilot maternal and child health and family planning service project in urban and rural areas of Lahore, Pakistan, was evaluated after 4 years (1984–1988). In this time the birth rate declined from 41.0 to 19.2, infant mortality from 119.0 to 70.2, and maternal mortality from 560 to 220 per 100,000 live births. Success was attributed to medical audit of services through peer review of performance.