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The research group wishes to thank the editors and the reviewers for their in-depth evaluations and really useful suggestions. This has helped us to revise the paper, which now focuses on the root-cause analysis, highlighting causes of poor high quality of care resulting in maternal deaths. The modifications are described in detail in the ‘response to reviewers’ doc. The modifications close to journal’s requirement are described within the cover letter. For only three out of 30 ladies did inadequate staff numbers appear to contribute to delays and/or insufficient administration.

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At least two researchers, drawn from a medically educated physician with health system evaluation expertise, an obstetrician, and a midwife, reviewed each case. They wrote detailed summaries, including notes on the terminal sickness. The evaluation focused on organizational and administration elements, group surroundings, individual staff information, and expertise and practices. This data included info on whether or not care was built-in or fragmented, and on communication, timeliness, referral, facilitation of transfers to hospitals and its follow-up, and organizational factors corresponding to availability of senior consultants. Each case summary was then reviewed by different team members and mentioned at evaluate conferences.

A) If there are ethical or legal restrictions on sharing a de-identified data set, please explain them in detail (e.g., knowledge comprise probably figuring out or delicate patient information) and who has imposed them (e.g., an ethics committee). Please also present contact information for a knowledge access committee, ethics committee, or other institutional physique to which information requests may be sent. Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but doesn’t fully meet PLOS ONE’s publication standards because it presently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the factors raised through the evaluate process. Recommendations to handle the components contributing to maternal mortality. For instance, there was an absence of recognition of the seriousness of a case of uncontrolled hypertension, with no plan or urgency about the state of affairs.

We will only publish funding data current in the Funding Statement part of the web submission kind. If you wish to make changes to your monetary disclosure, please embrace your up to date statement in your cover letter. Guidelines for resubmitting your figure information are available below the reviewer feedback at the finish of this letter. I agree with the comments made by Reviewer #2, that total Health news the paper must be shorter, more targeted on an important data, and edited for syntax, grammar and spelling. I look ahead to seeing the revised version the place I could provide additional comments. 20 women out of the 30 had a concomitant sickness, of whom 8 had CVD , four had pre-existing hypertension, 2 had hyperthyroidism, and one had TB, one HIV/AIDS, one diabetes, one renal disease, one retinoblastoma, and one weight problems.

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