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Despite a poorly performing main care system, a majority of the ladies arrived at both the frontline or the peak referral hospital in a situation where dying might need been prevented with higher quality hospital care. The government health care referral coverage states that, if a referral/transfer is required, a major care provider or centre ought to refer the affected person to the next level hospital Health news and never on to a better level hospital. This pyramidal referral system appeared to contribute to poor outcomes for 15 out of 30 deaths . Some women had been referred initially to hospitals the place their situation couldn’t be successfully managed. These ladies might need achieved better outcomes if they’d been referred on to the peak referral hospital.