Introduction: Maternal death audits were implemented in hospitals across Benin to reduce maternal mortality. This study aimed to assess the quality of these audits at the Departmental University Hospital Center of Borgou and Alibori (CHUD-B/A) between 2020 and 2023. Methods: This was an observational, cross-sectional, descriptive, and analytical study based on retrospective data collection conducted from May 20 to July 4, 2024. All maternal death audits carried out between January 1, 2020, and December 31, 2023, were included. Results: Out of 241 reported maternal deaths, 113 were audited (46.89%; 95% CI: 40.45 - 53.40), corresponding to 84 audit reports. Only 44.30% of the recommendations were implemented. The overall quality of the audits was rated as good in 70.24% of cases, moderate in 26.19%, and poor in 3.57%. The multidisciplinary composition of the audit team was significantly associated with audit quality (p = 0.007; 95% CI: 1.72 - 5.24). Conclusion: Efforts should be strengthened to increase the proportion of audited maternal deaths and ensure the effective implementation of audit recommendations.
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