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Some statutory changes to the legislation would be necessary to allow the mortality committees to report their data to the HQSC Central Repository Group. While local investigation and reflection on SAEs is to be commended, there may be perceived barriers to submitting reports, for example, time pressure, lack of perceived benefit, lack of recognition of an event as being a significant maternal morbidity, damage to the reputation of the organisation and duplication of reporting, all of which have been cited as strong disincentives to reporting adverse events in healthcare.18 Additionally, there may be a concern by healthcare workers about the potentially identifiable nature of case histories that are published in the report for each SAE. This is in contrast to the mandatory nature of reporting to the PMMRC, with corresponding statutory protection of information. The mandatory nature of reporting to the PMMRC may account for the differences in the two reports. We recognise that the selleck products purpose of SAE reporting and PMMRC reporting differs. It is also important to recognise that low reporting of SAE does not necessarily mean that lessons are not being learnt and that positive changes are not being made locally. However, we have identified under-reporting of maternal and perinatal SAEs to the HQSC, which suggests that a significant number of these cases are not undergoing adequate local review and that the report is not a useful way to monitor the quality, safety and experience of maternity services in New Zealand. Footnotes Contributors: CF conceived the idea for the paper. BK, VM and SA were responsible for the data gathering and extraction. SA wrote the initial draft, which was edited by LS, CF and VM. Competing interests: CF is the past Chair of the PMMRC. VM is the National Coordinator of the PMMRC. LS is the epidemiologist for the PMMRC. Provenance and peer review: Not commissioned; externally peer reviewed. Data sharing statement: Details of possible cases from published HQSC SAE reports were sent to the relevant DHB with a request that they provide National Health Index number and date of event.""Extensive evidence linking multiple sectors activities to health outcomes1 means that public health organisations are seeking to influence policy and planning activity in other sectors (for recent examples see?refs. 2�C4). However, the co-benefits of including population health concerns as a policy issue are not well understood or accepted by other sectors,5 6 partly driven by their primary roles in achieving specific other government objectives.