Table 2.

Challenges faced and action initiated for enhancing the maternal death review process

Challenges faced	Measures to address the challenge
Lack of understanding among nodal officers about MDR process	Repeated visits, organization of orientation sessions, and facilitation by helping in interview conduction
Error in the diagnosis and recording	Organization of orientation sessions, and evaluation of each case at district level with clearance of doubts
Incorrect/incomplete filling of MDR formats	Organization of orientation sessions
Death review of all cases not being done with missing of some death cases	Organization of orientation sessions with emphasis on importance of covering all deaths to all the health staffs, and involvement of vital registration system
Focus on on medical causes and ignoring nonmedical causes of death	Re-orientation sessions conductedfor identifying nonmecical/social causes
Blaming of staff and private practitioners	Repercussions of this problem explained, and advise given to take a supportive/supervisory role
Under and nil reporting due to the fear of punitive action	Organization of orientation sessions
Under reporting from tribal areas	Organization of orientation sessions, and approached community volunteers and social activists for support
Lack of private sector participation	Approached obstetrics and gynecology societies for support

MDR: Maternal death review