Maternal death is as much a social phenomenon as a medical event. Maternal death review (MDR), a strategy for monitoring maternal deaths, provides information on medical, social and health system factors that should be addressed to redress gaps in service provision or utilisation. To strengthen MDR implementation in the state of Andhra Pradesh, India. The project involved development of state specific guidelines, technical assistance in operationalization and analysing processes and findings of MDR in ten districts. 284 deaths were recorded over 6 months (April-September 2012) of which 193 (75.4 %) could be reviewed. Post-partum haemorrhage (24 %) and hypertensive disorders (27.4 %) followed by puerperal sepsis in the post-partum period (16.8 %) were the leading causes of maternal deaths. 68.3 % deaths occurred at health facilities. 67 % of mothers dying during the natal or post-natal period, delivered at home, though the death occurred in a health facility. Type 1 delay (58.9 %) was the most common underlying cause of death, followed by type 3 delay (33.3 %). Under or nil reporting from the facilities was observed. Program staff could identify broad areas of intervention but lacked capacity to monitor, analyse, interpret and utilize the generated information to develop feasible actionable plans. Information gathered was incomplete and inaccurate in many cases. Challenges observed showed that it will require more time and continuous committed efforts of health staff for implementation of high quality MDR. Successful implementation will improve the response of the health system and contribute to improved maternal health.

Context:The Food Safety and Standards Act have redefined the roles and responsibilities of food regulatory workforce and calls for highly skilled human resources as it involves complex management procedures.Aims:1) Identify the competencies needed among the food regulatory workforce in India. 2) Develop a competency-based training curriculum for food safety regulators in the country. 3) Develop training materials for use to train the food regulatory workforce.Settings and Design:The Indian Institute of Public Health, Hyderabad, led the development of training curriculum on food safety with technical assistance from the Royal Society for Public Health, UK and the National Institute of Nutrition, India. The exercise was to facilitate the implementation of new Act by undertaking capacity building through a comprehensive training program.Materials and Methods:A competency-based training needs assessment was conducted before undertaking the development of the training materials.Results:The training program for Food Safety Officers was designed to comprise of five modules to include: Food science and technology, Food safety management systems, Food safety legislation, Enforcement of food safety regulations, and Administrative functions. Each module has a facilitator guide for the tutor and a handbook for the participant. Essentials of Food Hygiene-I (Basic level), II and III (Retail/ Catering/ Manufacturing) were primarily designed for training of food handlers and are part of essential reading for food safety regulators.Conclusion:The Food Safety and Standards Act calls for highly skilled human resources as it involves complex management procedures. Despite having developed a comprehensive competency-based training curriculum by joint efforts by the local, national, and international agencies, implementation remains a challenge in resource-limited setting.

Organ donation: awareness a mustThis is with reference to a news item in the November 11, 2013 issue of the Times of india, "Organ Donation pledge on i-cards". According to the newspaper report, the move to encourage organ donation has been initiated by the state public health minister, Suresh Shetty. Mumbai University has issued a circular requesting all colleges to print stickers of the organ donation pledge and to distribute them among the students.Organ donation is a voluntary act. An individual can decide to donate his/her organs by declaring his/her intent to do so while alive, or the family can take such a decision after the death of a relative. An extensive campaign is required to promote a proper understanding of the organ donation pledge and to assist people in making an informed decision on this important issue. No such awareness campaign has taken place in the colleges of Mumbai University, to the best of our knowledge.We are aware that there is a severe shortage of organs for "cadaveric transplant" programmes in major hospitals. Sustained campaigns abroad have made it possible for organ donation pledges to appear on driving licences. However, i feel that there is a need for a vigorous debate on the subject among students, medical professionals, and the public at large, before initiating such a campaign. in the absence of such background work, the decision to promote organ donation is unfortunate and there is a need to intervene at the earliest to stop colleges from issuing stickers of the organ donation pledge.At the same time, a campaign to promote safe driving, both among those who drive two-wheelers and four-wheelers, may serve to save some young lives. Ratna Magotra, Consulting cardiac surgeon and former Head,