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Despite their condition being advanced or deteriorating, most of those girls arrived at the hospital in a state where it was possible to forestall dying with good quality care. Poor software of protocols, poor information move from frontline hospitals to the peak referral hospital, delays in emergency care, and delays in administration of deteriorating patients were the main contributing factors to those deaths. Pyramidal referrals also contributed, as many ladies had been initially referred to hospitals the place their situation couldn’t be successfully managed. While generic quality enchancment measures, notably coaching Health …