Table 1.

Strengths, weaknesses, opportunities and threats analysis at baseline

Strengths	Weaknesses
The Odisha state administration is committed for proper MDR with provision of support, and inter-sectorial coordination (in case needed) Government of India guidelines and tools for MDR are there for implementation at state level The electronic and print media in Odisha state are reporting the maternal deaths thereby putting pressure on the Government for taking steps to reduce the MMR Trained health staffs are already there for conduct of verbal autopsies	Monitoring of maternal deaths in the state is not fully operational No mechanism for assuring quality of MDR process including that from private facilities existing in the state There is no provision of technical guidance to districtsby the state government to report and monitor MDR (e.g., health staffs not sensitised regarding reporting, district level program officers not clear about their roles) Fear of punitive action among health staffs There is an overall poor record keeping, and HMIS in the state
Opportunities	Threats
Greater oppurtunity in the area of maternal death surveillance present There is opportunity to regulate private sector service quality for better MDR, and MMR reduction	There is a nonconfidentialexistence of MDR process at district level due to various reasons Electronic and print media hyping and blaming hospitals and dramatizing the events

MDR: Maternal death review, MMR: Maternal mortality rate, HMIS: Health management information system