Commentary: evaluating avoidable mortality in developing countries--an important issue for public health.

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Abstract
In the late 1970s, an American working group chaired by David D Rutstein introduced a method for measuring the quality of medical care.1 It was based on the tradition of using potentially avoidable mortality such as perinatal and maternal mortality as negative indicators of health and as a starting point for the evaluation of health care. Studies of the maternal and infant mortality rate have been useful. These rates, however, have the limitation that they only apply to mothers and infants. With the help of specialists in many fields of medicine 80 causes of death were defined as ‘unnecessary untimely deaths’. The list was based on judgements as to whether the conditions were amenable to preventive and/or therapeutic measures. An agglomeration of deaths from these causes would be warning signals indicating that the quality of medical care may need to be improved.