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According to the World Health Organisation (WHO), maternal death is defined as the death of a woman while pregnant or within 42 days of termination of pregnancy, irrespective of the duration and site of the pregnancy, from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes. Some of the major factors that contribute to maternal deaths are post-partum haemorrhage (PPH), Eclampsia, Septic Abortion and Ectopic. Others are delays in accessing health services, delay at the health facility and delay on the part of a woman in taking the decision to visit a health centre. There are also the problems of attitude of health staff, poor monitoring, inadequate planning and poor referral systems. Annual performance review Speaking at the 2013 Annual Performance Review of the Ghana Health Service (GHS) in Kumasi, the Ashanti Regional Director of Health Services, Dr Alexis Nang-Beifubah, indicated that the region recorded 200 maternal deaths last year as against 181 in 2012. He said the increased cases in maternal deaths continued to worry the health directorate and in view of that achievable plans had been put in place. He, however, said the region made a headway by achieving 110 per cent ante-natal care (ANC) coverage, and also increased post-natal coverage from 64 per cent in 2012 to 65 per cent in 2013, with skilled delivery reducing from 67 per cent in 2012 to 65 per cent in 2013. Stressing the theme for the review: �Strengthening Collaboration in Achieving MDGs four and five by 2015,� he said some interventions were initiated towards achievement of the MDGs four and five that were related to reducing infant mortality and improving maternal health. Interventions Among the interventions, he mentioned the setting up of a maternal task force to focus on Antenatal Care, development of friendly labour ward concept, working with traditional leaders and regional blood banks, as well as the implementation of the Millennium Accountability Fund (MAF). Dr Nang-Beifubah indicated that general staffing situation, especially general nursing had improved but expressed worry that the number of critical health specialists such as doctors, midwives, anaesthetists and physicians have not recorded any significant change. He also expressed worry that out of the 18 doctors who were posted to work in the region, only eight reported. He further indicated that the regional health directorate, in collaboration with the Komfo Anokye Teaching Hospital (KATH), had established specialist centres at Manhyia, Tafo, Kumasi South, Suntreso and Mampong hospitals to serve as training sites for housemanship programmes and also to reduce the pressure on KATH. On finance, he noted that financial inflows to the region from all sources decreased and time of their release were erratic with internally generated fund (IGF) being the main source of funding for the running of health facilities. The regional health director said the Ghana Health Service would focus on strategies such as discipline, improved financial management and service in the region and intensifying collaboration with partners and stakeholders.