Pyramidal referrals also contributed, as many ladies have been initially referred to hospitals where their condition couldn’t be successfully managed. While generic high quality enchancment measures, particularly coaching and monitoring for rigorous application of clinical protocols will help improve the situation, the districts and hospitals must develop capability to evaluate their native situation. Unless native organisational elements, workers data Health news and skill, blood and blood product availability, and local causes for delays in offering care are identified, it may not be possible to successfully cut back the antagonistic pregnancy outcomes. An important limitation was we didn’t have entry to the medical data at the frontline hospitals. Organisational and personnel elements, at both major care and in the hospitals, now contribute to nearly all maternal deaths in Indonesia.